The journal of headache and painReview
06 May 2025
In the sustainable development goals (SDG) context of seeking universal health coverage, the expanding gap between the supply of specialized and primary health-care providers of headache-related health care and the care needs of the very large number of people affected by headache is a formidable but not insoluble public-health challenge.
Structured headache services provide a cost-effective framework wherein controlled patient flows enable the care needs of people with headache to be met at appropriate levels, but these services may still be overwhelmed by inappropriate demand.
Community pharmacists are an underutilized resource, potentially well able to provide the solution. To do so, they must, as a profession, be integrated into structured headache services.
What remains to be determined is how to achieve this integration in an encouraging climate for change, which recognises the potential for relieving strained health-care systems and meeting a range of health-care needs by expanding pharmacists' scope of practice.
This position statement on behalf of the European Headache Federation (EHF) and Lifting The Burden (LTB) is formally endorsed by the International Pharmaceutical Federation (FIP).
Declarations. Ethics approval and consent to participate: Not required. Consent for publication: N/A. Competing interests: HBH declares no competing interest. CL has received consulting fees and honoraria for lectures and/or presentations from AbbVie/Allergan, Eli Lilly, Lundbeck, Novartis, Pfizer, and Teva, has participated in clinical trials as Eli Lilly’s principal investigator, is associate editor for The Journal of Headache and Pain, and immediate past president and current board member of the European Headache Federation. AMvdB has received personal fees as advisor and speaker from Allergan/AbbVie, Eli Lilly, Novartis, and Teva, has received research support from Manistee, Novartis, Pfizer, Satsuma and Tonix, declares independent research support from the Dutch Research Council and the Netherlands Organisation for Health Research and Development, is associate editor for The Journal of Headache and Pain, and current president of the European Headache Federation. FMA has received honoraria for lecturing and/or participating in advisory board meetings for AbbVie, Eli Lilly, Lundbeck, Novartis, Pfizer and Teva, is associate editor for Acta Scandinavica Neurologica, Frontiers in Neurology and Frontiers in Pain Research, is president of the Danish Headache Center and current board member of the European Headache Federation. LNC declares no competing interest. GC is associate editor of The Journal of Headache and Pain, Cephalalgia, Cephalalgia Reports, Frontiers in Neurology (Neurotechnology section) and Frontiers in Human Neuroscience (Brain Imaging and Stimulation section), and current board member of the European Headache Federation. CD has received honoraria and/or travel grants from Pfizer, Merck, Teva, AstraZeneca, Lundbeck, Teva and Orion Pharma, and is a current board member of the European Headache Federation. RGG has received personal fees for advisory board participation, speaker engagements and involvement in clinical trials from AbbVie, Amgen, Bayer, Eli Lilly, Grunenthal, Lundbeck, Merck, Novartis, Organon, Pfizer, Sanofi, Tecnifar and TEVA, and is a current board member of the European Headache Federation and of Lifting The Burden. PRH has received grants from Amgen, Eli Lilly, Kallyope and Bristol Myers Squibb, and honoraria and travel expenses in relation to educational duties from Allergan, Novartis, Teva, Pfizer and Almirall, and is a current board member of the European Headache Federation. AKH is a member of the Editorial Board of The Journal of Headache and Pain and a board member of Lifting The Burden. MP has received consultancy fees from Abbvie, and is co-founder and president of MiGRA Portugal – the Portuguese Migraine and Headache Patients’ Association. UR declares institutional fees to Universitätsmedizin Greifswald and Charité Universitätsmedizin Berlin, participation in advisory boards of Eli Lilly, AbbVie, Lundbeck, Eli Lilly, Novartis, Pfizer and Teva; consultations or scientific presentations for AbbVie, Lundbeck, Eli Lilly, Novartis, Medscape, Pfizer and Teva, has received research grants from Novartis Pharma (CHERUB 01), and is a current board member of the European Headache Federation. KR has received honoraria for contributions to advisory boards or oral presentations from Novartis, Teva, Lundbeck, AbbVie, Pfizer, Viatris and Berlin Chemie, and is a current board member of the European Headache Federation. MSdR has received consulting fees and honoraria for lectures and/or presentations from Eli Lily, Lundbeck, Novartis, Organon and Teva, has participated in clinical trials as the principal investigator for Lundbeck, and is second vice president of the European Headache Federation. HWS has received consultant fees from Lundbeck, Pfizer, Abbvie, Lilly and Novartis, and is chairman of the Education Committee of the International Headache Society. ET is a current board member of the European Headache Federation. JV has received personal fees and nonfinancial support from Pfizer, Lilly and Teva, personal fees from Novartis and Lundbeck, and grants and nonfinancial support from Allergan/AbbVie, and is a current board member of the European Headache Federation. TJS is associate editor of The Journal of Headache and Pain and a board member of Lifting The Burden. No author declares competing interests relevant to this statement.
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