Abstract
Background
In a global comparison, in 2006 Germany was the first in the world to switch naratriptan to an OTC medication but since then only almotriptan has been switched. Therefore, Germany has fallen behind recently because of the failure to carry out further switches.
Objectives
The aim of this extensive evaluation of various surveys among pharmacies, physicians, patients and stakeholders was to investigate whether there is an obvious need for an Rx-to-OTC switch of further triptans. In addition, reasons for or against such a switch should be evaluated.
Setting
The surveys were distributed in several ways. Most were based on online tools and were performed in 2017, 2018 and 2019.
Methods
Several surveys have been initiated using different methodologies. The pharmacist surveys were only conducted digitally. The physician surveys were first digitally based on an online platform. A paper form could also be edited manually and returned by fax. The respective questionnaires consisted of 5 to 17 questions on the topic of switching and could all be answered in about 5 to 10 min. BAH Health Monitor hosted the patient surveys and included telephone interviews. The stakeholder survey was performed by personal interviews. The surveys on economic calculations among patients were conducted digitally.
Main outcome measure
Sumatriptan and other Rx triptans are suitable and should be switched to OTC status.
Results
Nine hundred forty pharmacists and pharmaceutical technical assistants took part in the initial pharmacist survey. In the subsequent pharmacist surveys, the volume of participants was even higher and reached almost 4000. For the physician survey, 540 answers were received, and the BAH Health Monitor addressed about 1000 telephone interviews. Within the stakeholder survey, 24 interviews were carried out with 32 participants from a range of professional backgrounds; most are part of the German switch process. Finally, the patient survey related to economic calculations was based on 175 answers. Seventy percent of the participating physicians < 50 years old supported a switch of further triptans. For the question about how safe OTC triptans are, 41% of the 3568 participants from the Marpinion pharmacy survey voted that they are safe.
Conclusion
With a Rx-to-OTC switch of further triptans, patients would have an easier, faster and safe way to treat their migraine attacks.
Impact of findings on practice statements
The outcome of these surveys and interviews provides information for all participants in the German switch process about their decision-making behaviour. Furthermore, it allows deeper insights into patients’ needs and may help to fulfil them. The results can provide information about the German process and German needs worldwide and stimulate discussion about Rx-to-OTC switches.
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Funding
These studies were funded in full by the German Medicines Manufacturers’ Association (BAH) with a grant of about €80,000 (net).
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Andrea Stippler, Elmar Kroth and Niels Eckstein declare that the design, evaluation and writing had no funding.
Elmar Kroth is a member (not entitled for vote) of the Expert Advisory Committee for Pharmacy-Only Issues in Germany and Managing Director of Scientific Affairs at BAH. Niels Eckstein is a professor at the University of Applied Sciences Kaiserslautern. Andrea Stippler is studying drug research at the University Bonn and is doing an internship at BAH.
Other than the above-mentioned conflicts, Andrea Stippler, Elmar Kroth and Niels Eckstein declare that they have no conflict of interest.
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Stippler, A., Eckstein, N. & Kroth, E. Key results of a series of surveys among German pharmacies, physicians, patients and stakeholders regarding further triptans as potential OTC products. J Public Health (Berl.) 30, 409–415 (2022). https://doi.org/10.1007/s10389-020-01310-2
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DOI: https://doi.org/10.1007/s10389-020-01310-2