During June and July 2025, we conducted an online survey asking people about their use of triptans for migraine and the need for more medication options to treat migraine attacks.
New Zealand deserves more migraine-specific acute medications. We only have two triptans, which are the migraine-specific medications used when you have a migraine attack. Globally seven triptans are available, and we need more in NZ because they all act a bit differently and what suits one person might not work for someone else. We also deserve to have a triptan nasal spray. A nasal spray is recommended for people who have severe nausea and vomiting with their migraine attacks, because it gets absorbed through the nose and bypasses the stomach.
We’ve published our survey results, and our New Zealand migraine community agrees. Most people who answered the survey had tried triptans (although use of the injectable sumatriptan was low, which may mean this isn’t being recommended to people even when it could be a good option). The two available triptans didn’t work for everyone and caused side effects in some. Two thirds wanted to try another type of triptan. There was a strong consensus that as well as more triptans, we also need a broader range of effective and funded migraine treatments, for both acute treatment of migraine attacks and preventive treatment.
One triptan Pharmac has assessed for funding is zolmitriptan, which is available as a nasal spray. This is on Pharmac’s ‘cost saving or cost neutral’ priority funding list. This means Pharmac is willing to fund zolmitriptan if it can be supplied at the same or lower cost than a comparable medication – in this case, sumatriptan.
In 2023, Pharmac proposed to remove this application. We made a submission opposing the removal, which was supported by our Clinical Advisory group and in 2024, Pharmac decided to keep the application active. We undertook the survey on triptan use to provide more evidence to Pharmac about the need for additional triptans, like zolmitriptan. We shared the survey results with Pharmac and requested an update about the zolmitriptan application.
Pharmac responded by noting that “the supplier has not previously been willing to bring zolmitriptan in New Zealand. We intend to discuss this further with the supplier to establish if there is any possibility of supply in New Zealand and likely timeframes.” Pharmac also explained that they’re unable to take the zolmitriptan application to one of their Advisory Committees for review until they have confirmed that a supplier is willing to make zolmitriptan available in New Zealand.
We indicated we would be keen to present the survey findings whenever the zolmitriptan application came before a committee. This was well received and Pharmac commented: “Committee members have previously remarked on how valuable your presentation was during the assessment of CGRP-targeted migraine prophylactics.”
We appreciate Pharmac’s response and intentions to undertake discussions with the supplier. We will also distribute the survey results to pharmaceutical companies that make zolmitriptan and other triptans, to make them aware of the opportunity there is to bring more triptans into New Zealand.
