Advocates Request More Funding for Pain Research during Headache on the Hill

Marius Birlea, MD, FAHS

On February 12–13, the Alliance for Headache Disorders Advocacy organized the 11th annual edition of the “Headache on the Hill.” This is a unique opportunity for patients and their families, headache providers and scientists to interact with legislators and advocate for pressing issues in the field. The single most important problem to address has been identified, and solutions for it have been proposed under a bipartisan bill introduced in both the Senate and House of Representatives as the Opioids and Stop Pain Initiative Act (S.2260/H.R. 4733).

The annual societal cost of the pain and opioid crisis has been estimated at $1.1 trillion per year, making it the most costly U.S. health problem ever. Back/neck pain and migraine are the 1st and 2nd leading causes of all global disability. For millions of chronic pain sufferers (30% of the US population) and those around them, discovery of new effective and non-addictive pain treatments means everything. With few treatment options, ~81 million American adults in pain are prescribed 80% of the world’s opioids.

There have been no new drugs approved for pain since 2004 (Lyrica and Prialt, discovered through National Institutes of Health (NIH)-sponsored research). A highly relevant study published just last week in Proceedings of the National Academy of Sciences in (PNAS) underscores the indispensable nature of NIH research to pharmaceutical development. This work demonstrates that NIH funding was associated directly or indirectly with every one of the 210 new molecular entities (NMEs) approved from 2010–2016 and “suggests that the scale of this contribution is larger than generally appreciated.”

Taking into account the high impact seen, current NIH funding for pain research is exceedingly low compared to other diseases, at 0.07% of the NIH budget for migraine, for example. The proposed bill is asking for emergency appropriation of dollars for new NIH research to: understand pain, discover and develop non-addictive pain therapies — pharmacological or non-pharmacological — and discover and develop medication-assisted and opioid overdose reversal treatments.

This new NIH research, based on the provisions in the bill, will be guided by the Federal Pain Research Strategy, a national consensus plan to study pain. The bill will fund the federal contribution to the public-private partnership of NIH with the pharmaceutical industry, and create a Pain Therapeutics Screening Program to accelerate therapy development. In this context, three of my colleagues and I, representing the University of Colorado Headache program, met with relevant staff in congressional offices of two senators and three representatives from our state. Based on our encounters with numerous patients lacking pain relief with current therapies and the data presented, we asked the congressional offices to co-sponsor the bill above.

Our stories were listened to carefully and the discussions were engaging, contributing to raising the awareness of the critical chronic pain and opioids problem. With advocates from 42 states, sustaining more than 200 such meetings, the overall event was highly successful and promising. With continued advocacy efforts, we hope that the bill will be passed and, consequently, important advances will be made to change the game of fighting pain for millions of sufferers.

Marius Birlea, MD, FAHS, is assistant professor of neurology at the University of Colorado Denver School of Medicine.

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Without research, there is no hope.
The Honorable Paul G. Rogers