Transcript Snímek 1

The Migraine management
in Turkey
Mustafa Ertaş
Department of Neurology
Istanbul Faculty of Medicine
Country description
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Population is 72.1 million in 2005
Life expentancy is 71.3 years
Urbanized population (2005) is 67%
Population:
10 million for Istanbul
4 million for Ankara (capital city)
• GNI per capita is 4.750 US$
• HC (Health Care) expenditure is 3-5% of GNP
Health care system
• Regulations: Strict
• Reimbursement:
State
Private Health Insurance Companies
• Reference for pricing:
Lowest price among European Union countries
Health care system
• Reimbursement for triptans: (80% of price)
– Oral forms if prescribed by neurologist without report
– Any physician may prescribe if the patient has report
– Subcutan form is subjected to report
– All forms up to 6 doses per month
Current situation in migraine management
• Prevalence:
Nationwide home based Migraine prevalence study
(1998)
in Turkey:
16.4% at 15-55 age range
22.8% in women
10.9% in men
Current situation in migraine management
• Diagnosis: By GPs and Neurologists
– ID Migraine test (3-item test)
• Therapy: Mostly GPs treat migraine (w/o triptans)
• Barriers:
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there is no headache treatment guideline
self medication (no prescription needed)
low awareness of migraine in patients and physicians
high price of triptans compared to analgesics
PRICE: 1 tb sumatriptan 50 mg = 117 tb aspirin
The role of Headache Society, Centers and
Specialists in migraine management
Turkish Neurological Society Headache Study Group
includes headache specialists and
headache-interested physicians, and
represents Turkey in European Headace Federation
The role of Headache Society, Centers and
Specialists in migraine management
Turkish Neurological Society Headache Study Group
• Treatment
preparing headache treatment guideline (about to
finish)
The role of Headache Society, Centers and
Specialists in migraine management
Turkish Neurological Society Headache Study Group
• Education
– organizing Annual Headache School for 6 years
for neurologists and GPs (5 days, ~ 250 people)
– organizing local meetings for neurologists and
GPs in different cities (~10 meetings a year)
The role of Headache Society, Centers and
Specialists in migraine management
Turkish Neurological Society Headache Study Group
• Coordination
coordinating national headache multicenter studies
(drug trials, clinical studies, prevalence studies)
The role of GPs in migraine management
• Part in migraine treatment
– Mostly GPs treat migraine patients
– cannot start triptans but repeat prescription
• Education
– Lectures on headache at Medical Faculties (6 years)
are 1-2 hours
– Postgraduate headache education by Turkish
Neurological Society and meetings supported by
industry
The migraine awareness among population
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Specialist: improving
GPs: modestly improving by postgraduate educat.
Patients: improving by media
Current days – future- ideal status
Medication overuse headache: ~2%
The POSSIBILITIES how to IMPROVE it!
• Key activities:
Meetings with GPs and specialists
Headache courses for GPs and specialists
Media interviews
• International cooperation:
Increasing the local center numbers in
multinational trials