Researchers at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences have recommended expanded access to triptans, a class of drugs used for acute treatment of migraine headaches, in Ontario.
The recommendations follow a review of their usage by the Ontario Drug Policy Research Network published today in the journal Headache.
“Our review shows that triptans work to effectively manage migraine headaches, but strict provincial regulations mean that few patients who could benefit from these drugs are able to get them through the public system,” said Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and a principal investigator of the ODPRN.
“However, unlike other provinces, Ontario doesn’t limit the quantity for patients who do receive triptans through the public drug program, which means these patients may be at a higher risk of medication-overuse headaches, and that leads us to recommend changes to the current program,” said Gomes, a scientist with ICES.
The researchers recommended expanded access to triptans in Ontario to address accessibility issues identified in earlier studies, while imposing quantity limits that would reduce the risk of medication overuse headaches.
“Our review shows that people with migraines would have much easier and safer access to these drugs, with only marginal cost increases if the government expanded access to these drugs while limiting the number of doses a person could receive at one time. Less restrictive reimbursement policies on triptans could potentially increase accessibility 20-fold, from 1,200 patients to 25,000 patients with a three-fold increase in annual costs, from $1.8 million to $5.6 million,” said Gomes.
The drug class review includes four studies that found:
- Triptans are effective and safe for treatment of acute migraine, with many patients noting that these drugs help restore daily functionality and the ability to work.
- Affordability of triptans was a key concern impacting access, especially for patients who are low-income and/or do not have private drug coverage.
- Triptan prescribing and volume of use for public drug coverage varied significantly between provinces, the lowest rates observed in Ontario (4 per 10,000) and the highest in Manitoba (100 per 10,000).
- Under the existing reimbursement system, approximately one in 10 triptan users eligible for public drug plan coverage in Ontario was prescribed quantities of triptans that might place them at risk of medication overuse headaches.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
For more information or to arrange an interview with Tara Gomes, please contact:
Manager, Media Strategy, St. Michael’s Hospital
Media Advisor, ICES
(o) 416-480-4780 or (c) 416-434-7763