Table 4
Drug/Route | Unique
ID | Unique
Claims | Total
Paid | Average
paid claim | Average Claim dispense | Combo
Triptan Therapy* | <=
Proposed quantity Limit (%) | >
Than 1x <=2x of limit (%) | >
2x of limit (%) | |||||
| ALMOTRIPTAN | ORAL | 105 | 313 | $30,044 | $95.99 | 9.5 | 7 |
6.7% | 278 | (88.8%) | 20 |
(6.4%) | 15 |
(4.8%) |
| FROVATRIPTAN | ORAL | 33 | 73 | $10,461 | 143.30 | 10.1 | 3 |
9.1% | 60 | (82.2%) | 7 |
(9.6%) | 6 |
(8.2%) |
| NARATRIPTAN | ORAL | 144 | 524 | $102,210 | $195.06 | 11.8 | 6 | 4.2% | 307 | (58.6%) | 153 | (29.2%) | 64 | (12.2%) |
| RIZATRIPTAN | ORAL | 467 | 1742 | $258,099 | $148.16 | 10.1 | 16 | 3.4% | 1567 | (90.0%) | 101 | (5.8%) | 74 | (4.2%) |
| SUMATRIPTAN SUMATRIPTAN SUMATRIPTAN SUMATRIPTAN | NASAL ORAL SQ COMBINED | 210 1185 337 1593 | 677 4452 1726 6855 | $91,986 $779,358 $375,246 $1,246,590 | 135.87 $175.06 $217.41 | 6.6 11.6 2.2 | 8 40 43 |
3.8% 3.4% 12.8% | 601 3093 818 | (88.8%) (69.5%) (47.4%) | 71 844 374 |
(10.5%) (19.0%) (21.7%) | 5 515 534 |
(0.7%) (11.5%) (30.9%) |
| ZOLMITRIPTAN | ORAL | 603 | 2293 | $335,551 | $146.34 | 10.0 | 17 | 2.8% | 1176 | (51.3%) | 821 | (35.8%) | 296 | (12.9%) |
| BUTORPHANOL | NASAL | 51 | 300 | $47,325 | $157.75 | 5.1 | ||||||||
| DHE | NASAL | 38 | 113 | $10,283 | $91.00 | 4.3 | ||||||||
| Misc. Ergot† | 136 | 452 | $33,656 | $74.46 | 41.0 | |||||||||
| Total | 2801 | 12665 | $2,074,219 | 7900 | (66.9%) | 2391 | (20.3%) | 1509 | (12.8%) | |||||
| *Defined as two different agents filled for two consecutive months; † cafergot, DHE 45 injection, Ergoloid mesylates, Ergomar | ||||||||||||||
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