Evaluation of a Monthly Coverage Maximum (Drug-Specific Quantity Limit) on the 5-HT1 Agonists (Triptans) and Dihydroergotamine Nasal Spray

Hoffman, Lauren A.; Mayzell, George; Pedan, Alex; Farrell, Maureen; Gilbert, T.M.

doi:10.18553/jmcp.2003.9.4.335

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…Two longitudinal, retrospective review studies of medical and pharmacy claims in HMOs found that limits on monthly triptan access reduced drug costs. Nevertheless, the two studies (conducted in 1999 and 2003) had conflicting findings as to the effect of these limits on other health‐care resource costs, with the first study finding that additional migraine‐related costs did not significantly change, and the second study finding reduced costs [67,68]. Nevertheless, in one of the above‐cited studies on sumatriptan limitation, Goldfarb and colleagues noted that as sumatriptan use was reduced, prescriptions for drugs that could be used for migraine prevention increased by 33.9% [67].…”

Section: Evolution Of Economic Evaluations Of Migraine Therapies Follmentioning

confidence: 99%

The Burden of Migraine in the United States: Current and Emerging Perspectives on Disease Management and Economic Analysis

Hazard¹,

Munakata²,

Bigal³

et al. 2009

Value in Health

143

125

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Migraine imposes a substantial burden on patients, families, employers and societies. The economic standards by which migraine and treatment are evaluated have evolved in response to clinical developments. Emerging evidence suggests that migraine is a chronic and progressive disease. If confirmed, approaches to acute and prophylactic treatments and economic evaluations of migraine treatment may require major reconsideration.

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Section: Evolution Of Economic Evaluations Of Migraine Therapies Follmentioning

confidence: 99%

The Burden of Migraine in the United States: Current and Emerging Perspectives on Disease Management and Economic Analysis

Hazard¹,

Munakata²,

Bigal³

et al. 2009

Value in Health

143

125

View full text Add to dashboard Cite

show abstract

“…Other studies describing the percentage of triptan users, in periods when more triptans are available, are reported in Table 4 [5, 6, 8–15]. The prevalence of triptan users in a year period was 0.55–1.4%.…”

Section: Literature Reviewmentioning

confidence: 99%

Triptans in the Italian population: a drug utilization study and a literature review

Panconesi¹,

Pavone²,

Vacca³

et al. 2008

J Headache Pain

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Previous studies performed in selected populations show a poor utilization of triptans for migraine. The objectives of our study were to establish patterns of triptans utilization in a large sample, covering 1/10 of Italian population (5.57 millions), and to perform a review of published studies on this topic. We investigated drug prescription database collected during 2006 from 33 health authorities distributed in 8 different regions. About 0.6% of the subjects received at least one prescription of triptans in 1 year: 77.7% were females and 22.3% males. Age distribution shows that 9.5% of patients were aged above 65, and received prescriptions for 8.2% of packages. The review of the literature suggests that these percentages of utilization are common to several countries, and shows that occasional triptan users who received only one prescription in 1 year are a large percentage (40–60%); moreover, a minor population of triptan users utilize a large amount of total triptans. Finally triptans are frequently prescribed in people aged above 65 years, a population in which triptans are contraindicated or not recommended. Our study and the analyzed ones indicate suboptimal treatment of migraine patients with triptans and also an incorrect use in some patients (triptan abusers, elderly).

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“…Finally, managed care organizations continue to examine the use of migraine-specific drugs closely because of cost considerations. 100,101 We recommend that pharmacists place priority on addressing the following five goals: to familiarize themselves with the last decade's advances regarding this illness, including its pathophysiology, as well as the genuine risks of agents specifically designed for migraine; to improve the disappointing diagnosis rate by educating individuals with headache that a recurrent pattern of episodic headache attacks and associated symptoms that interfere with work, family, or social function are in high likelihood migraine and require physician intervention; to reduce the overuse of inappropriate or ineffective "pain killer" drugs such as butalbital-containing agents and OTC products; to promote limits of use of appropriate acutetreatment drugs and to detect patients who exceed these limits and guide them toward appropriate care; and to expand the use of proven and evolving drug, nondrug, and other management techniques that reduce pain and preserve function, such as early intervention and stratified care. 9,11,21,66,67,95,[102][103][104]…”

Section: Challenges For Pharmacistsmentioning

confidence: 99%

Migraine Headache Misconceptions: Barriers to Effective Care

et al. 2004

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Migraine headaches affect 12% of the adult population in the United States and cause a significant economic loss due to decreased workplace productivity Although interactions between pharmacists and individuals with headache are common, few pharmacists receive adequate training regarding migraine therapy. We refute several misconceptions that hinder effective care, such as that migraine is a vascular disease, triptans cause rampant cardiacrelated morbidity and even mortality, a best oral triptan exists, sinus and tension headaches are prevalent, and migraine is a minor economic problem. Our pathophysiologic understanding demonstrates that migraine is a neurologic process of the trigeminovascular system, of which vascular effects are secondary. This process can result in a myriad of clinical signs and symptoms, often leading to a misdiagnosis of sinus or tension headache. The last decade's experience with triptans in more than half a billion people worldwide reveals a benign adverse-effect profile, particularly when taken early in an attack. Published reports and real-world experiences illustrate that these drugs do not merit fears of triptan-induced cardiac consequences in appropriately selected individuals. Society's productivity loss due to migraine is measured in billions of dollars. Restoring a patient's ability to function normally is now recognized as the primary treatment goal, not merely relieving pain. Thus, the overreliance on "pain killer" drugs such as butalbital-containing products and the continued underutilization of migraine-specific drugs need to be addressed. Opportunities exist for pharmacists and other health care providers to dispel continually propagated migraine misconceptions and familiarize themselves with advances in therapy. Such actions will benefit patients, the health care system, and society as a whole.

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Evaluation of a Monthly Coverage Maximum (Drug-Specific Quantity Limit) on the 5-HT1 Agonists (Triptans) and Dihydroergotamine Nasal Spray

Cited by 6 publications

References 13 publications

The Burden of Migraine in the United States: Current and Emerging Perspectives on Disease Management and Economic Analysis

The Burden of Migraine in the United States: Current and Emerging Perspectives on Disease Management and Economic Analysis

Triptans in the Italian population: a drug utilization study and a literature review

Migraine Headache Misconceptions: Barriers to Effective Care

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