Neurologist Dr. Antanas Vaitkus

The Migraine management in Lithuania

Lithuania

• Demography• Population 3.4 Mio (Men 43%, Women 57%)• Capital – Vilnius (population 542 809)

• Economy• EU accession 2004• GDP per capita 2034 €• GDP growth +8%• Inflation rate (MAT) 5.5%• Health care spendings per capita 124 € • Avg. growth 17%

Country description

Health care system• Description of key Regulatory / Reimbursement

assumptions• A and B reimbursement lists for Rx products

• Not clear enough timing of the reimbursement list updates (should be every 4 months)

• Fixed prices for reimbursed products (in local currency - LT)

• Reference price system based on average of 5 countries CIP prices – minus 5%

• 4 levels of reimbursement : 100%, 90%,80%, 50%

• Reimbursement/ triptans - 50% after NEU prescription for 1 year. Negotiations with authorities regarding better reimbursement conditions for the patients.

Current situation in migraine management• Diagnostic – neurologists (1year after the

diagnosis the patient can receive the reimbursed prescription and medicine, self diagnostic still very popular.)

• Therapy – mainly NSAID’s.

• Barriers – low awareness among patients, low awareness among GP’s, self medication, high treatment price.

The role of Headache Society, Centers and Specialists in migraine management

• Headache society was established in 1992 in Lithuania.

• Activity of Headache society is connected with 5 regional neurologists associations (in the biggest cities).

• There are 8 Headache Centers with 15 Headache specialists/neurologists working in there.

• International co-operation – with Scandinavian Headache Society.

The role of GPs in migraine management

• Part in migraine treatment – they don’t want to treat migraine.

• Education - low education about migraine (don’t know how to diagnose).

• Guidelines – still pending. There are no any

guidelines confirmed.

The POSSIBILITIES how to IMPROVE it!

• Key activities – to establish sumatriptan as a first line treatment of migraine (GPs and Neurologists guidelines), increase awareness about modern and highly effective treatment of migraine among specialists and GP’s, increase awareness about modern and highly effective treatment of migraine among patients. To gain OTC status for Cinie 50 mg N2.

• International cooperation – International migraine school (university?), migraine meetings, seminars, etc.

THANK YOU FOR YOUR ATTENTION!