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Migraine
treatment financial headache for national healthcare systems
London
- More than 70 million people suffer at the hands of migraines globally*
and the quality of treatment for the affliction is currently far from
ideal. The triptan class is considered the
gold standard in migraine treatment, yet despite the dramatic effects on
everyday life that migraine sufferers
deal with, a new report from independent market analyst Datamonitor**
has revealed that due to economic constraints within national healthcare
systems, some patients aren’t getting the best available treatment.
70 million lives affected
A migraine is a primary neurobiological disorder, which manifests
itself as recurring attacks, usually lasting from four to 72 hours. An
estimated 5-12% of the global
population is classified as suffering from migraine, some 74 million
people in the seven major pharmaceutical markets*, while between
23% and 42% of migraineurs report more than 24 attacks in the previous
12 months. The attacks, which can interfere greatly with the everyday
lives of sufferers, involve unilateral
throbbing headache pain of moderate to severe intensity, and also
usually involve nausea, sometimes vomiting, and/or
photo and phonophobia (sensitivity to light and sound).
However, approximately half of all migraineurs do not seek medical
advice, and of those who do, only 3-19% are prescribed triptans, says
Datamonitor central nervous system
analyst Emma Travis. “The most commonly used current treatment are
simple analgesics like Excedrin, which are used by 20-50% of
patients, but current migraine treatment is only effective in 20-30% of
patients. Not surprisingly, Datamonitor’s research has also indicated
that only 20-50% of patients are
satisfied with their current treatment.”
Triptans the cornerstone
Although the triptan class is considered the well-established
cornerstone of migraine therapy, there is a significant delay between
patient’s first experience of
migraine symptoms and triptan use. First-line therapy predominantly
utilises simple analgesics and non-steriodal anti-inflammatory drugs
(NSAIDs), despite the lack of sustained anti-migraine effect seen with
these products and the risk of rebound headaches, Travis says.
“Datamonitor
believes that by educating both primary care providers (PCPs) and
patients alike, the growth in the wider and earlier use of the triptan
class will be accelerated.”
Despite the fact that triptans are not always prescribed as first line
treatment, (mostly for economic rather than medical reasons) opinion
leaders spoken to by Datamonitor
remain convinced they are the most effective medication:
‘ [Triptans] are the most efficacious drugs without any doubt. You can
use them via several routes, which is also very important in clinical
practice; via a nasal, mouth intake- even
via the mouth with a wafer formulation, or subcutaneous.’
Opinion leader spoken to by Datamonitor
‘All my patients, or 99% of my patients are given a triptan option,’
However the good news for patients is that the use of triptans may soon
be accelerated by the arrival of generics onto the market. Oral forms of
GlaxoSmithKline’s sumatriptan (the first
triptan released on the market and still the top seller in the class)
are expected to lose patent protection from
2006 and 2009 in the EU and US, respectively. It is inevitable that
these cheaper generics will take market share from the more expensive,
branded triptans, Travis says.
“A cheaper, generic triptan would allow more migraine sufferers access
to the best available medication, however it is something of an
indictment on modern healthcare
services that they are not as widely used as possible already. While
pragmatism has to dictate healthcare expenditure to a certain extent,
given the dramatic effect migraine has on the everyday lives of
sufferers, one could make a reasonable argument that they should get the
best available medication.”
Notes
*Global
is defined in this instance as the seven major pharmaceutical markets,
which are France, Germany, Italy, Japan, Spain, UK, USA.
** Commercial Insight: Migraine - A Painful Future for the Triptans?
(28/1/05)
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