Assessment of Clinical, Service, and Cost Outcomes of a Conversion Program of Sumatriptan to Rizatriptan ODT in Primary Care Patients With Migraine Headaches

Abstract

It is estimated that 6% of men and 18% of women in the United States suffer from migraine headaches. Approximately 10% of primary care office visits are for headaches, with the majority being for migraines.1 The impact of migraine headaches on pain, disability, and general health results in a significant financial burden as it is estimated that the U.S. spends $14 billion annually on migraine treatment, including missed workdays and associated loss of productivity.

Treatment Persistence and Switching in Triptan Users: A Systematic Literature Review

“…8,9,17 A study conducted by Ifergane et al showed that this one-time filling behavior was more prevalent among men, ages <30 or >70, and users of 50-mg sumatriptan (vs 100 mg). 10 Five studies reported rates of discontinuation of all triptan therapy (Table). Reasons for discontinuing included lack of efficacy or side effects (78%), uncertain diagnosis of migraine (39.2%), and reduction in headache frequency (33.3%).…”

“…In some cases, patients were given surveys to gather their opinions of triptan therapy. Five studies used data from the US; 6,[9][10][11][12] one study reported data exclusively from the United Kingdom (UK); 13 one from the Netherlands; 8 one from Israel; 14 one from Italy; 15 one from France; 16 one from Denmark; 17 and one utilized a combined data set from the UK, France, and Germany. 18 The sample sizes of included studies ranged from 343 to 40,892.…”

“…8 A study conducted by Gershovich et al focused solely on rizatriptan orally disintegrating tablets and reported the lowest rate of one-time filling at 22%. 10 Five studies reported rates of discontinuation of all triptan therapy (Table). 6,11,13,15,18 Using patient survey data, Holland et al found that 34.6% of American migraine patients using triptans in 2008 no longer reported using triptans in 2009.…”

Evolution, Current Structure, and Role of a Primary Care Clinical Pharmacy Service in an Integrated Managed Care Organization

“…5–7 During this time, therapeutic interchange programs allowed the organization and patients to realize cost savings. 8,9 While performing therapeutic interchanges, PCCPS specialists also addressed DRPs such as medication adverse effects or polypharmacy and used follow-up surveys to document favorable patient satisfaction with PCCPS. 8 Additional efforts were made to improve patient safety and support physicians through laboratory monitoring of high-risk drugs.…”

Actual Versus Projected Cost Avoidance for Clinical Pharmacy Specialist -Initiated Medication Conversions in a Primary Care Setting in an Integrated Health System

“…Previous studies of medication conversion programs within our organization have documented improved quality outcomes and high patient satisfaction with clinical pharmacy specialist interventions in statin conversions 2 and triptan conversions for migraine syndrome. 27 Additionally, patients receiving care from a clinical pharmacy specialist are encouraged to contact the clinical pharmacist with questions or problems and are provided with a contact telephone number. If an ADE resulting in a hospitalization or ER visit occurred, the patient may not have had the opportunity to contact the clinical pharmacy specialist.…”