{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T09:38:47Z","timestamp":1765791527216,"version":"3.48.0"},"reference-count":19,"publisher":"CSIRO Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1196900"],"award-info":[{"award-number":["GNT1196900"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute migraine episodes affect &amp;gt;18% of Australians. Triptans are most effective when taken early in migraine attacks, making timely access critical. Before February 2021, triptans were prescription-only, but a downscheduling policy change enabled over-the-counter (OTC) purchase with pharmacist advice. This study examined the effect on subsidised Pharmaceutical Benefits Scheme (PBS) dispensing rates and illustrative patient costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Aggregated PBS dispensing data were used to estimate monthly triptan dispensing rates per 1000 people using population data from the Australian Bureau of Statistics. As PBS data excludes OTC supply, we projected dispensings, and illustrate potential costs based on pre-downscheduling trends to estimate the potential shift to OTC. PBS beneficiaries include concessional (social security recipients\/low-income earners) and general (those ineligible for concessions). Prescription costs were based on a four-tablet PBS pack of sumatriptan 50\u00a0mg (A$7.70 concessional; up to A$24.60 general). OTC costs were estimated using a two-tablet pack (A$10.00 standard pharmacy, A$7.00 discount pharmacy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Before downscheduling, triptan dispensings grew 1.4% monthly, slowing to 0.6% post-downscheduling. By illustration, we estimate that shift to OTC access would have led to a cost saving of up to A$2\u00a0million for general patients, but an increased cost of A$2.3\u20135.8\u00a0million for concessional patients, depending on pharmacy pricing models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Downscheduling slowed PBS dispensing growth. If reduced PBS dispensing was offset by OTC access, the policy may have improved timely migraine treatment, although PBS use remains high. Cost benefits depend on patient concession status and potential offsets, such as reduced doctor visits, which should be considered in further policy evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/ah25050","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T23:16:55Z","timestamp":1753744615000},"source":"Crossref","is-referenced-by-count":1,"title":["Effect and illustrative costs of downscheduling on government subsidised dispensings of triptans in Australia: a 10-year analysis"],"prefix":"10.1071","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4171-3504","authenticated-orcid":true,"given":"Jack","family":"Janetzki","sequence":"first","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacinta","family":"Johnson","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Kalisch Ellett","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Ni","family":"Ho","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Hall","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ward","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Pratt","sequence":"additional","affiliation":[{"name":"AClinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."},{"name":"BQuality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"2025121504334131600_R1"},{"key":"2025121504334131600_R2"},{"issue":"4","key":"2025121504334131600_R3","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1111\/j.1468-2982.2008.01546.x","article-title":"Early vs. Non-Early Intervention in Acute Migraine \u2014 \u2018Act When Mild (AwM)\u2019. A Double-Blind, Placebo-Controlled Trial of Almotriptan.","volume":"28","author":"Goadsby","year":"2008","journal-title":"Cephalalgia"},{"issue":"3","key":"2025121504334131600_R4","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1177\/0333102411433042","article-title":"Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study.","volume":"32","author":"Lant\u00e9ri-Minet","year":"2012","journal-title":"Cephalalgia"},{"key":"2025121504334131600_R5"},{"key":"2025121504334131600_R6"},{"key":"2025121504334131600_R7"},{"key":"2025121504334131600_R8"},{"key":"2025121504334131600_R9","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.8134","article-title":"Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists.","volume":"7","author":"Booth","year":"2019","journal-title":"PeerJ"},{"key":"2025121504334131600_R10"},{"key":"2025121504334131600_R11"},{"key":"2025121504334131600_R12"},{"key":"2025121504334131600_R13"},{"issue":"2","key":"2025121504334131600_R14","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/ane.12727","article-title":"Triptan use in Australia 1997-2015: A pharmacoepidemiological study.","volume":"136","author":"Eyre","year":"2017","journal-title":"Acta Neurol Scand"},{"key":"2025121504334131600_R15"},{"issue":"12","key":"2025121504334131600_R16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084088","article-title":"Economic Impact of a triptan Rx-To-OTC Switch in Six EU Countries.","volume":"8","author":"Millier","year":"2013","journal-title":"PLoS One"},{"issue":"3","key":"2025121504334131600_R17","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.jval.2018.09.2840","article-title":"Cost-Effectiveness of Reclassifying Triptans in Australia: Application of an Economic Evaluation Approach to Regulatory Decisions.","volume":"22","author":"Parkinson","year":"2019","journal-title":"Value Health"},{"issue":"8","key":"2025121504334131600_R18","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1007\/s40273-019-00804-6","article-title":"Is Reclassification of the Oral Contraceptive Pill from Prescription to Pharmacist-Only Cost Effective? 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