Background

A new international survey called the SEALANT study looked at how doctors treat migraines in seven countries across Southeast and East Asia. The results show that patients in these areas face massive roadblocks when trying to secure migraine specialist access Southeast Asia regions currently offer, severely delaying proper care for their headaches.

Southeast and East Asia include a mix of wealthy and developing nations, meaning healthcare systems and medicine prices vary wildly from country to country. While international medical guidelines say patients should get quick, accurate diagnoses and specific migraine drugs, putting those rules into practice is very difficult in poorer areas.

The SEALANT study asked real-world doctors about their daily practices to find out what is holding back proper migraine care.

How the Study Was Done

The SEALANT study used an online survey that ran from late 2024 to mid-2025.

• The Doctors: The study collected answers from 686 licensed doctors who treat migraines, and about 80% of them were neurologists (brain specialists).
• The Places: The doctors lived in seven different places: Laos, Indonesia, Malaysia, the Philippines, Singapore, Taiwan, and Thailand.
• Economic Groups: To compare wealthy areas with poorer areas, the study grouped the countries by their wealth status:
  • High-Income: Singapore and Taiwan.
  • Upper-Middle Income: Indonesia, Malaysia, and Thailand.
  • Lower-Middle Income: Laos and the Philippines.

Study Results

The survey found major gaps in care, especially in poorer countries. Here are the main findings:

• Not Enough Specialist Clinics: 70.0% of the doctors said their country does not have enough brain or headache clinics, and this problem was worst (87.2%) in poorer countries.
• Unfair Distribution of Doctors: There is a massive gap in resources; for example, Singapore has one brain specialist for every 35,000 people, while Laos only has one for every one million people.
• Missed Diagnoses: Only 60.0% of patients already had a correct migraine diagnosis before they finally got to see a specialist.
• Long Waiting Times for Answers: Nearly half of the patients (44.9%) had to deal with severe headaches for more than a full year before getting a correct diagnosis.
• Rushed Appointments: About 60% of doctors are only allowed to spend 15 minutes or less per patient, meaning they have to rush through prescribing pills instead of teaching patients how to manage their condition.
• Missing Migraine Medications: Standard painkillers (like ibuprofen) are everywhere, but only 28.5% of doctors said their patients frequently use triptans, which are advanced medications made specifically for migraines.
• Too Many Opioids: Even though international medical rules say not to use opioids (strong, addictive narcotics) for migraines, 76.2% of doctors still prescribe them occasionally.
• Rebound Headache Risks: Only 34.7% of patients understood that overusing standard painkillers can actually backfire and cause more headaches (called medication overuse headaches).
• New Advanced Drugs are Too Expensive: While basic pills are easy to get, newer, highly effective migraine-specific treatments (called CGRP therapies) are only available in about half of the clinics because they cost too much out-of-pocket.
• Disagreements on Insurance Coverage: While 77.1% of doctors agree these new advanced drugs work great, only 69.8% believe the government should pay for them, because the drugs are simply too expensive compared to what the average local worker earns.

Why These Roadblocks Exist

The researchers explained that migraines are often dismissed as an “invisible illness,” so governments do not give the issue enough funding or attention.

Also, a strange paradox happens in these regions: patients can book appointments quickly, but because so many people flood the clinics, doctors are forced to rush through visits in 15 minutes or less. This lack of time leads to poor care, causing patients to rely on cheap over-the-counter painkillers, which often makes their headaches worse over time.

Conclusion

The SEALANT study proves that to fix migraine care in Southeast and East Asia, healthcare systems need an upgrade. Countries need to better train family doctors, stop the over-use of dangerous opioids, and find ways to make advanced, modern migraine medicines affordable for everyday people.