Prescribing patterns of anti-migraine medicines in South Africa using a claims database

Background Migraine is an expensive condition impacting on the economically active sector of the population. Given the expense of anti-migraine medicine, it is important to monitor the impact of generic prescribing and therapeutic substitution. Objective The primary aim was to analyse the prescribing patterns and cost of anti-migraine medicines to determine the impact of generic prescribing and prescribing changes over time. Method A retrospective drug utilisation study was conducted on South African private sector medical insurance claims data for 2011. Results A total of 797 patients received 1583 anti-migraine medicines during 2011. The majority of patients (70.14 %) were females. The average age of patients was 41.61 (SD = 14.91) years. Clonidine was the most frequently prescribed (49.21 % of prescribing frequency; 25.70 % of cost), followed by the triptans [selective serotonin (5-HT_1B/1D)-receptor agonists] (27.98 % of prescribing frequency; 45.92 % of cost). Five triptans were prescribed. The average cost per sumatriptan prescription was the lowest (the only triptan with generic equivalents). Rizatriptan was the most frequently prescribed triptan (18.51 % of prescribing frequency; 29.15 % of cost). Conclusion The results were generally in agreement with previous South African studies. The impact of the introduction of newer triptans and of generic equivalents on prescribing patterns was clear.