Findings from New York University Langone Medical Center Broadens Understanding of Headache (Variation in Prescription Drug Coverage for Triptans:…

Findings from New York University Langone Medical Center Broadens Understanding of Headache (Variation in Prescription Drug Coverage for Triptans: Analysis of Insurance Formularies)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Current study results on Nervous System Diseases and Conditions - Headache have been published. According to news reporting out of New York City, New York, by VerticalNews editors, research stated, "To analyze triptan coverage by insurers to examine (1) possible disparities in coverage for different formulations (oral, intranasal, etc) and (2) quantity limits and stepped care requirements to obtain triptans. Triptans are FDA approved migraine abortive medications."

Financial supporters for this research include Dr. Mia Minen is a recipient of the American Academy of Neurology-American Brain Foundation Practice Research Training Fellowship, American Academy of Neurology-American Brain Foundation Practice Research Training Fellowship.

Our news journalists obtained a quote from the research from New York University Langone Medical Center, "Patients frequently state that they have difficulty accessing triptans prescribed to them. We searched the 2015 drug formularies of commercial and government health insurers providing coverage in NY State. We created a spreadsheet with all of the commercially available triptans and included information about covered formulations, tier numbers and quantity limits for each drug. We then calculated the number of listed plans that cover or do not cover each triptan or triptan formulation, the total number of medications not covered by an insurance provided across all of its plans, as well as the percentage of plans offered by individual companies and across all companies that covered each drug. We also calculated the number and proportion of plans that imposed quantity limits or step therapy for each drug. Of the 100 formularies searched, generic sumatriptan (all formulations), naratriptan, and zolmitriptan tablets were covered by all plans, and rizatriptan tablets and ODTs were covered by 98% of plans. Brand triptans were less likely to be covered: 4/36 Medicaid plans covered brand triptans. Commercial insurers were more likely to cover brand triptans. All plans imposed quantity limits on 1+ triptan formulations, with >80% imposing quantity limits on 14/19 formulations studied. Almost all plans used tiers for cost allocation for different medications. Generic triptans were almost always in Tier 1. Brand triptans were most commonly in Tier 3. Approximately 40% of brand triptans required step therapy, compared with 11% of generic triptans."

According to the news editors, the research concluded: "There are substantial variations in coverage and quantity limits and a high degree of complexity in triptan coverage for both government and commercial plans."

For more information on this research see: Variation in Prescription Drug Coverage for Triptans: Analysis of Insurance Formularies. Headache, 2017;():. (Wiley-Blackwell - www.wiley.com/; Headache - onlinelibrary.wiley.com/journal/10.1111/(ISSN)1526-4610)

Our news journalists report that additional information may be obtained by contacting M.T. Minen, Dept. of Neurology, New York University Langone Medical Center, New York, NY, United States. Additional authors for this research include K. Lindberg, A. Langford and E. Loder.

Keywords for this news article include: Headache, New York City, United States, Drugs and Therapies, North and Central America, Nervous System Diseases and Conditions.

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