OBJECTIVES: Migraine can be treated pharmacologically and/or non-pharmacologically by a range of options. The 5-HT1B/1D receptor agonists (triptans) have become a preferred abortive treatment option for migraine despite their high cost. The aim was to analyse the prescribing cost of triptans in a South African private sector patient population.

METHODS: A retrospective pharmacoepidemiological study was conducted on 2018 data. All antimigraine preparations (Anatomical Therapeutic Chemical (ATC) classification N02C) were extracted from a private healthcare administrative database.

RESULTS: A total of 901 antimigraine preparations were prescribed to 503 patients (70.78% females). The average age of patients was 40.89 (SD=14.21) years. Patients received on average 2 antimigraine products over the year. Clonidine was the most often prescribed (40.84% of products), followed by the triptans (30.08%) and ergotamine (21.82%). Rizatriptan prescriptions accounted for 26.64% of antimigraine products, and for 43.38% of cost, indicating that they were proportionally more expensive than the other antimigraine preparations. Rizatriptan was the most popular triptan (88.56% of all triptan prescriptions). Three different rizatriptan trade name products were prescribed. The originator product was available as both a tablet and wafer, while the generic products were available as orally disintegrating tablets. Compared to the results of previous studies, generic triptans have changed antimigraine prescribing patterns.

CONCLUSIONS: The triptans are preferred agents to abort migraine attacks despite their cost. Rizatriptan wafers was the clear triptan of choice in this study. The introduction of generic equivalents for rizatriptan may have contributed to its higher prescribing rate compared to other triptans.