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Public Drug Coverage and Its Impact on Triptan Use Across C anada: A Population‐Based Study
Author(s) -
Amadio Anthony,
Lee Kathy,
Yao Zhan,
Camacho Ximena,
Knowles Sandra,
Lay Christine,
Paterson J. Michael,
Hunt Jordan,
Gomes Tara
Publication year - 2015
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12508
Subject(s) - triptans , medicine , medical prescription , population , migraine , reimbursement , headaches , emergency medicine , environmental health , health care , psychiatry , economics , pharmacology , economic growth
Background Public drug coverage for triptan medications varies across jurisdictions in C anada, which may lead to differences in usage patterns and patient risk for medication overuse headache. Methods We conducted a population‐based, cross‐sectional analysis of publicly funded triptan use in seven provinces across C anada from J anuary 1, 2012 to D ecember 31, 2012. All patients who had filled at least one prescription for a triptan during the study period were included. We defined quantity limits of 6, 12, and 18 triptan units per month to assess the prevalence of high volumes of triptan use, which may place patients at risk for medication overuse headaches, and compared this prevalence between provinces with different funding restrictions. Results We identified 14,085 publicly funded users of triptans in 2012 in the seven provinces studied, 82.5% of whom were aged less than 65 years (N = 11,631). The prevalence of triptan use ranged substantially by province, from 0.04% in O ntario to a maximum of 1.0% in M anitoba ( P < .001). Furthermore, the percentage of patients in each province using more than 6, 12, or 18 units per month differed significantly between provinces ( P < .001). In particular, the percentage of patients treated with more than 6 units per month ranged from as low as 2.1% in S askatchewan to 43.8% in O ntario. Conclusions Differing public drug reimbursement criteria for triptans may be one contributing factor that has led to our observation of considerable variation in both prevalence of triptan prescribing and potential overuse of these medications. We offer that monthly quantity limits may be considered as a tool to decrease risks for medication overuse headache.