title: Utilization of triptans in Sweden; analyses of over the counter and prescription sales.
abstract: OBJECTIVE
  To enable easier access to triptans, the drug of choice for moderate to severe migraine, some countries have made triptans available without prescription, that is, over the counter (OTC). Concern has been raised about this. The aim of this study was to describe the utilization pattern of triptans in Sweden before and after the OTC switch.
  
  
  METHODS
  Wholesaler and aggregated sales data from all Swedish pharmacies 1991 to 2011 and patient identity data on dispensed prescriptions 2007 and 2011 from the Swedish National Prescribed Drug Register were used to investigate volume and expenditure of triptans. The databases contain complete data for all drugs sold in Sweden or dispensed to all Swedish inhabitants (9.5 million in 2012).
  
  
  RESULTS
  Volumes of triptans have increased to 7.0 million defined daily doses (DDD) on prescriptions and 0.7 million DDDs OTC in 2011. Prescriptions were dispensed to 10.0 and 10.1 per 1000 inhabitants in 2007 and 2011, respectively. Although half of those dispensed triptans in 2007 were not in 2011, the incidence remained stable at 2.8 patients per thousand person-years. In 2011, the 10% of the heaviest users accounted for 44% and 48% of dispensed triptans in women and men, respectively.
  
  
  CONCLUSIONS
  Triptans OTC and the volumes dispensed on prescription have increased as has the DDD per patient purchasing triptans on prescription. However, the number of patient's dispensed triptans on prescription has remained stable. A concern is that almost half of prescribed triptans are purchased by 10% of the users.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden; Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mia
authors.initials: M
authors.lastname: von Euler
authors.forename: Sara
authors.initials: S
authors.lastname: Keshani
authors.forename: Katarina
authors.initials: K
authors.lastname: Baatz
authors.forename: Bjorn
authors.initials: B
authors.lastname: Wettermark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D013548:Sweden; D014363:Tryptamines / Q000627:therapeutic use*
chemical_list: D004366:Nonprescription Drugs; D014363:Tryptamines
keywords: drug utilization; migraine; over the counter; pharmacoepidemiology; prescription; triptan