Federal Policymakers Signal New Openness to Home Oxygen Treatment for Cluster Headache

Patients suffering from cluster headache may soon enjoy a breath of fresh air. The Centers for Medicare and Medicaid Services announced last month a proposed decision to make home-use oxygen a coverable treatment for cluster headache.

If the proposed decision becomes final, it may represent the most important policy victory for cluster headache patients in years. About 1 in 1,000 Americans suffer from cluster headache, an agonizing condition causing pain that’s comparable to kidney stones or gunshot wounds.

Oxygen Therapy

High-flow oxygen therapy has been used to treat cluster headache since the early 1950s. It’s a safe, effective and inexpensive treatment – usually the preferred treatment among providers and patients alike. But since 2011, federal policy has not covered home-use oxygen for cluster headache for Medicare patients, citing a lack of clinical evidence.

As the headache community has been documenting for years, several peer-reviewed studies support the benefits of oxygen therapy for treating cluster headaches. Given the unpredictability of attacks, however, clinical trials involving actual Medicare patients would be difficult to organize. And given the frequency and severity of symptoms, current guidance – that patients go to the emergency room or a provider’s office – is unrealistic.

A Victory for the Headache Community

Educating federal officials and other policymakers about these facts has been an ongoing project of the Alliance for Headache Disorders Advocacy, The Headache & Migraine Policy Forum and Clusterbusters, among other advocacy organizations.

Winning CMS’ approval of home oxygen therapy for cluster headache is a top priority of the Headache Disease Policy Action Network’s PLAN 2025 – to save patients time and suffering, and get them back living pain-free lives with their friends, family and coworkers.

Next Steps

Soon, CMS will release a final decision on this policy. And there is reason to hope the agency’s policy is favorable to those who have been negatively impacted for far too long.

Those who’ve been struggling with cluster headache for years look with optimism toward a time when they’ll have access to a treatment that’s safe, effective and within reach: oxygen.

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