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

Area of Science:

• Pharmacoeconomics
• Neurology
• Public Health

Background:

• Public drug coverage for triptan medications differs across Canadian provinces.
• This variation may influence triptan usage patterns and the risk of medication overuse headache (MOH).

Purpose of the Study:

• To analyze the prevalence of publicly funded triptan use across seven Canadian provinces.
• To assess the variation in triptan prescribing and identify potential overuse based on monthly quantity limits.

Main Methods:

• Population-based, cross-sectional analysis of triptan use from January 1, 2012, to December 31, 2012.
• Inclusion of all patients with at least one triptan prescription fill during the study period.
• Definition of monthly quantity limits (6, 12, 18 units) to assess high-volume triptan use and compare prevalence across provinces.

Main Results:

• 14,085 publicly funded triptan users identified in 2012; 82.5% were under 65 years old.
• Triptan use prevalence varied significantly by province, from 0.04% in Ontario to 1.0% in Manitoba.
• Significant differences observed in the percentage of patients exceeding monthly quantity limits (6, 12, or 18 units) between provinces.

Conclusions:

• Disparities in public drug reimbursement criteria for triptans likely contribute to variations in prescribing and potential overuse.
• Implementing monthly quantity limits for triptans may be a strategy to mitigate the risk of medication overuse headache.