Despite the effectiveness of triptans in treating migraine, nowhere near enough sufferers are getting the drugs in order to treat the affliction, according to a new report from Datamonitor.

Around 74 million people suffer from migraines in the seven major pharmaceutical markets – France, Germany, Italy, Japan, Spain, the UK and the USA – “and the quality of treatment for the affliction is currently far from ideal,” says the study.

Half of all “migraineurs” do not seek medical advice, and of those who do, only 3-19% are prescribed triptans, according to Datamonitor central nervous system analyst Emma Travis, who notes that the most common treatment is with simple analgesics, used by 20-50% of patients and only effective in 20-30% of them.

Furthermore, although the triptan class is considered the gold standard of migraine therapy, there is a delay between patient’s first experience of symptoms and triptan use. First-line therapy predominantly utilises analgesics and non-steroidal anti-inflammatory drugs “despite the lack of sustained anti-migraine effect seen with these products and the risk of rebound headaches,” Ms Travis claims.

Education of primary care providers and patients is the key to promoting triptans, says the reports, which quotes “opinion leaders” as saying they are the most effective medication because they can be used via several routes.

Datamonitor says that triptans are not always prescribed as first-line treatment mostly for economic rather than medical reasons, but this could change with the arrival of generics onto the market. The report claims that oral forms of GlaxoSmithKline’s Imitrex/Imigran (sumatriptan), the first triptan and still the top seller in the class, are expected to lose patent protection from 2006 and 2009 in the EU and USA, respectively, so “it is inevitable that these cheaper generics will take market share from the more expensive, branded triptans.” However, GSK has already taken to the courts to stop Indian generics manufacturer selling a copycat version of Imitrex [[05/01/04e]].

Ms Travis concludes by saying that generics will give more migraine sufferers access to the best medication: “However it is something of an indictment on modern healthcare services that they are not as widely used as possible already.”