Removing barriers to appropriate migraine treatment: Formulary limitations and triptan package size

Stephen D. Silberstein, David Dodick, Jim Kesslick

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

The main goals in the pharmacologic management of migraine headache are to avert or relieve debilitating pain, prevent escalating acute medication use, and improve day-to-day functioning. This review will examine the evidence supporting the early use of acute medication, usually when pain is mild, to enhance patient outcomes. We will also discuss imposed quantity limits as a practical impediment to the implementation of this strategy in the managed care setting, and will identify strategies for overcoming this barrier to effective care. Quantity limits imposed on triptan therapy by health plans can hinder the optimal acute treatment of migraine. A standard triptan quantity limit sufficient to permit early migraine treatment and a movement by manufacturers to provide blister packs consistent with a standard quantity limit should reduce patients costs, permit brand mobility when appropriate, and bolster long-term cost effectiveness by removing an important impediment to the use of triptans when they are most effective, early in the migraine attack when pain is often still mild.

Original languageEnglish (US)
Pages (from-to)1250-1254
Number of pages5
JournalHeadache
Volume45
Issue number9
DOIs
StatePublished - Dec 1 2005

Keywords

  • Formulary
  • Managed care
  • Migraine
  • Pharmacoeconomics
  • Triptans

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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