The prohibitive cost of migraine medication is causing sufferers to think twice before reaching for their pain relief, writes FIONA REDDAN
FOR THE 500,000 migraine sufferers in Ireland, it is not just their chronic illness which is giving them headaches, but the cost of medication to treat it.
While the cost of migraine medication has been an issue for some time, it has been exacerbated by falling incomes and the recent hike in the monthly limit of the Drugs Payment Scheme to €120.
And, although the cost of many drugs were reduced last month by 40 per cent under the Irish Pharmaceutical Healthcare Association’s (IPHA) “Check the List” scheme, migraine medications such as Imigran were not included, on the grounds that they did not meet criteria such as the price of the medicine already having been reduced.
Migraine is a very common condition in Ireland, affecting 12-15 per cent of the population. While the most well-known symptom may be a headache, migraine sufferers also complain of nausea, vomiting, diarrhoea, confusion and, in rare cases, temporary paralysis and loss of speech. As such, many sufferers are subscribed preventative medicine for periods of between six months and a year.
However, Esther Tomkins, a clinical nurse specialist in headache/migraine at Beaumont Hospital, says cost is definitely becoming more of an issue for patients, with more people looking for cheaper options. In some cases, the cost puts people off taking the medication altogether, with the cost of 10 Imigran tablets, frequently used to prevent migraines, costing upwards of €85.
Marina Forrestal has been taking migraine medication for the past six months or so to treat her frequent migraines but found she was regularly put off taking the drug due to the cost involved.
She was prescribed Imigran, which is taken when the patient feels the onset of a migraine, but found that filling her prescription for 10 tablets a month was costing her €100 – or €10 a tablet – a price which made her hesitant to actually use the drug.
“I would look at the tablet, and say ‘will I or won’t I take it’. Ten euro will do that,” she says.
Other patients look to less expensive over-the-counter analgesics to help treat their pain, but as these are not as strong or as effective, people take a higher dose over a longer period of time which can lead to other problems.
“Over-using a drug like Nurofen Plus, which contains codeine, can lead to medication over-use headaches, which can be difficult to treat,” says Tomkins.
It is no surprise then, that given the high cost of medication, more migraine sufferers now purchase their medication when abroad.
On a visit to Newry, Forrestal tried to get her prescription filled, and both she and the pharmacist were shocked with the outcome. When asked by the pharmacist whether she would accept a generic alternative – something she was never asked in the Republic – she duly purchased Sumatriptan tablets.
And the price? Twenty tablets for £20 – or £1 a tablet.
Forrestal got an even better deal when visiting her aunt in Manchester. At the airport on the way home she managed to purchase 10 tablets of the generic version of the drug for just £4.95 – or 50p a tablet.
Now, she feels “freer to take it [the drug]” adding, “people should be able to take their medications”.
Although several generic equivalents of Imigran were introduced in Ireland in 2007, including the brands Sumatran (by Rowex), Migrastat (Gerard Laboratories) and Sumatriptan Niche (Niche Pharmaceuticals), many migraine sufferers, such as Forrestal, are unaware of these options, as they are not offered this alternative.
Generic drugs tend to cost about 20 per cent less than the original drug, and are only made available once the patent attained by the pharmaceutical firm which developed the original product runs out.
Triona Casey, a civil servant who is bearing the brunt of public sector pay cuts, finds she is struggling to meet the cost of her medication every month, which includes Frovex, used for the acute treatment of migraine pain.
As the cost of her drugs exceed the level set by the Drugs Payment Scheme, she has to pay just €120 a month. However, this works out at €1,440 a year, up by €240 on last year, and she too is considering getting her prescription filled when on holiday.
Tomkins, however, who frequently finds her patients buying medication abroad, recommends that patients get their prescriptions filled in Ireland.
“I think if they’re prescribed here, and you receive the exact same medication abroad then that’s fine. But it could be a variant and it’s all in a foreign language,” she says.
But, as long as such significant price differentials exist in Ireland, it is unlikely her advice will be heeded.
12-15%of the population suffer from migraine
€85is the cost of 10 Imigran tablets, which are used to prevent migraines
€120a month is the level set by the Drugs Payment Scheme
Did you know...that generic drugs cost about 20 per cent less than the original drug, and are only made available once the patent attained by the pharmaceutical firm which developed the original product runs out
