Public Drug Coverage and Its Impact on Triptan Use Across <scp>C</scp>anada: A Population‐Based Study

Amadio, Anthony; Lee, Kathy; Yao, Zhan; Camacho, Ximena; Knowles, Sandra R.; Lay, Christine; Paterson, J. Michael; Hunt, Jordan; Gomes, Tara

doi:10.1111/head.12508

Cited by 5 publications

(11 citation statements)

References 18 publications

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“…For acute treatment, triptans are contraindicated in patients with cardiovascular disease [ 25 , 26 ]. Drug costs or restrictions on prescribing and/or coverage may further limit triptan accessibility for many patients [ 27 , 28 ]. Long-term frequent use of triptans, as may be needed for cCH management, can in turn lead to the development of medication overuse headache [ 29 , 30 ], which, although rare, has been reported in patients with CH [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of non-invasive vagus nerve stimulation for the treatment of chronic cluster headache

et al. 2016

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BackgroundCluster headache (CH) is a debilitating condition that is generally associated with substantial health care costs. Few therapies are approved for abortive or prophylactic treatment. Results from the prospective, randomised, open-label PREVA study suggested that adjunctive treatment with a novel non-invasive vagus nerve stimulation (nVNS) device led to decreased attack frequency and abortive medication use in patients with chronic CH (cCH). Herein, we evaluate whether nVNS is cost-effective compared with the current standard of care (SoC) for cCH.MethodsA pharmacoeconomic model from the German statutory health insurance perspective was developed to estimate the 1-year cost-effectiveness of nVNS + SoC (versus SoC alone) using data from PREVA. Short-term treatment response data were taken from the clinical trial; longer-term response was modelled under scenarios of response maintenance, constant rate of response loss, and diminishing rate of response loss. Health-related quality of life was estimated by modelling EQ-5D™ data from PREVA; benefits were defined as quality-adjusted life-years (QALY). Abortive medication use data from PREVA, along with costs for the nVNS device and abortive therapies (i.e. intranasal zolmitriptan, subcutaneous sumatriptan, and inhaled oxygen), were used to assess health care costs in the German setting.ResultsThe analysis resulted in mean expected yearly costs of €7096.69 for nVNS + SoC and €7511.35 for SoC alone and mean QALY of 0.607 for nVNS + SoC and 0.522 for SoC alone, suggesting that nVNS generates greater health benefits for lower overall cost. Abortive medication costs were 23 % lower with nVNS + SoC than with SoC alone. In the alternative scenarios (i.e. constant rate of response loss and diminishing rate of response loss), nVNS + SoC was more effective and cost saving than SoC alone.ConclusionsIn all scenarios modelled from a German perspective, nVNS was cost-effective compared with current SoC, which suggests that adjunctive nVNS therapy provides economic benefits in the treatment of cCH. Notably, the current analysis included only costs associated with abortive treatments. Treatment with nVNS will likely promote further economic benefit when other potential sources of cost savings (e.g. reduced frequency of clinic visits) are considered.Trial registrationClinicaltrials.gov identifier NCT01701245, 03OCT2012.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of non-invasive vagus nerve stimulation for the treatment of chronic cluster headache

et al. 2016

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“…Of the 3269 publications identified in the search, 29 met the inclusion criteria for this review ( Table 1 ). 6 , 8 , 20 – 23 , 29 – 51 All studies were observational, with half adopting a survey-based cross-sectional design. The remaining studies used a variety of methodologies, including a retrospective database analysis, physician survey, case-crossover design, and retrospective chart review.…”

Section: Resultsmentioning

confidence: 99%

“…8 Further details on triptan use among patients with migraine in real-world settings were also reported. 29,44 Comparing provincial differences in triptan use, Amadio et al analyzed publicly funded triptan dispenses in Alberta, Manitoba, New Brunswick, Nova Scotia, Ontario, Saskatchewan, and Prince Edward Island. 29 That study highlighted differences in the prevalence of triptan use among provinces, ranging from 0.04% in Ontario (N ¼ 1090) to 1% in Manitoba (N ¼ 6555).…”

Section: Acute Medicationmentioning

confidence: 99%

Epidemiology and treatment utilization for Canadian patients with migraine: a literature review

Graves¹,

Gerber²,

Berrigan³

et al. 2022

J Int Med Res

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The objective of this narrative review was to identify real-world evidence regarding the burden of migraine in Canada. We conducted a literature search in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews for studies published between August 2010 and August 2020. Of the 3269 publications identified, 29 studies were included. Prevalence estimates varied widely across Canada, and mental health comorbidities were common. Individuals with migraine have a lower quality of life, detrimental impact on workforce productivity, and higher rates of health care resource utilization (HCRU), with HCRU and costs highest among those with chronic migraine. We found inconsistencies in care, including underutilization of medications such as triptans, and varied utilization of over-the-counter and prescription medications. Increased medication use was identified among those with chronic migraine, and only a small number of patients used migraine preventive medications. The burden of migraine in Canada is substantial. Reduced quality of life and workforce productivity, increased HCRU and costs, and underutilization of triptans and migraine preventive medications highlight an important need for more effective management of individuals with migraine.

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“…Another study showed that, compared to those covered by private insurance, uninsured migraineurs and patients covered by Medicaid were less likely to receive standard migraine treatment, including abortive and preventive medications . Reimbursement for triptans also appears to affect their use in other countries such as Canada …”

Section: Discussionmentioning

confidence: 99%

Variation in Prescription Drug Coverage for Triptans: Analysis of Insurance Formularies

et al. 2017

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Public Drug Coverage and Its Impact on Triptan Use Across Canada: A Population‐Based Study

Cited by 5 publications

References 18 publications

Cost-effectiveness analysis of non-invasive vagus nerve stimulation for the treatment of chronic cluster headache

Cost-effectiveness analysis of non-invasive vagus nerve stimulation for the treatment of chronic cluster headache

Epidemiology and treatment utilization for Canadian patients with migraine: a literature review

Variation in Prescription Drug Coverage for Triptans: Analysis of Insurance Formularies

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