# Usefulness of the Support Video “Talking Picture Book” for Overcoming Hesitancy to Start Galcanezumab Therapy

## TL;DR

A Japanese video called 'Talking Picture Book' helped many migraine patients overcome hesitancy to start an expensive new therapy.

## Contribution

The study shows a video can effectively support patient decisions to start anti-CGRP therapy for migraines.

## Key findings

- 79.8% of patients gained a better understanding of migraine after watching the video.
- 52.4% of patients actually started the anti-CGRP antibody therapy after viewing the video.
- Patients with more monthly migraine days were more likely to start the therapy.

## Abstract

Galcanezumab, approved in April 2021, is the first humanized monoclonal antibody against the calcitonin gene‐related peptide (CGRP) ligand to become available in Japan, but some patients with migraine are hesitant to start an anti‐CGRP antibody for a variety of reasons, particularly its high price. To address this, a video in Japanese called “Talking Picture Book,” which aims to alleviate patients’ concerns about the anti‐CGRP antibody, was released as support material in Japan in March 2022.

Between December 2022 and May 2023, we conducted a questionnaire survey of 34 consecutive patients who had just viewed the video in order to evaluate its effectiveness in persuading hesitant patients to start an anti‐CGRP antibody.

Of these 34 patients, 79.8% gained a better understanding of migraine, 61.8% expressed a willingness to try galcanezumab, and 52.4% (11 patients) actually started the anti‐CGRP antibody. The number of mean monthly migraine days was significantly greater in those 11 patients than in the others. Multivariable logistic analysis of factors contributing to the decision to start anti‐CGRP antibody treatment revealed significant associations with monthly migraine days (odds ratio, 1.30; p = 0.01) and patients’ willingness to try anti‐CGRP antibodies (odds ratio, 9.82; p = 0.04).

This material was particularly useful for patients with a high number of monthly migraine days who had been hesitant to start the therapy. “Talking Picture Book” is a useful material that complements physicians’ explanations of the therapy, and it is desirable that such video materials be adapted for use in other countries in the future.

“Talking Picture Book” is a useful material that complements physicians. explanation of the therapy, and it is desirable that such video materials be adapted for use in other countries in the future.