Triptan persistency among newly initiated users in a pharmacy claims database

Abstract

Migraine patients were more likely to discontinue their triptan after their index prescription than at any other time in their prescription refill history. The majority of patients did not persistently refill triptans, but filled prescriptions for non-specific migraine therapies such as opioids and non-steroidal anti-inflammatory drugs. Reasons for triptan discontinuation warrant further investigation.

A novel intranasal breath-powered delivery system for sumatriptan: a review of technology and clinical application of the investigational product AVP-825 in the treatment of migraine

“…Observational studies consistently show low persistence with triptan therapy and frequent switching due to a number of factors, including formulary restrictions, adverse events, perceived lack of efficacy and cost [17][18][19][20]. Patients report dissatisfaction with the speed of effect, degree of relief, and tolerability of their acute migraine medication, and most patients (80%) are willing to try a new therapy [21].…”

Treatment adherence among new triptan users: a 2-year cohort study in Taiwan

“…We adopted a similar methodology to those applied in retrospective cohort studies of a pharmacy claims database in the United States and nationwide practice databases in Europe [16,17]. …”

“…Among the five cohorts, at the time of the first refill, 25–45% of triptan users continued the index triptan, 53–66% discontinued the index triptan, and 25–55% stopped all acute migraine medications [16,17]. Approximately 5–7% of US and European triptan users switched to alternative triptans, compared to only 0.01% in Taiwan.…”

“…Approximately 5–7% of US and European triptan users switched to alternative triptans, compared to only 0.01% in Taiwan. The proportion of between-class switchers was higher in Taiwan and the United States than in Europe [17,16]. Most between-class switchers in the United States switched to opioids or barbiturates, whereas they primarily shifted to NSAIDs or ergot derivatives in Taiwan [16,17].…”

“…Despite the widely reported efficacy and tolerability of triptans, several studies showed that the discontinuation of triptans was high [13-15]. According to a US pharmacy claims database and European nationwide practice databases, more than 50% of newly prescribed triptan users never refilled their first triptan prescriptions during a 2-year follow-up [16,17]. Moreover, only ~10% of newly prescribed triptan users continued to use the same triptan that was originally prescribed in a 2-year follow-up period [16,17].…”