First, may I say the triptans are a marvelous class of drug? When you’re wading through a 5 day migraine and liquids, not to mention solid food, are a distant memory. When the right side of your brain wakes you up every hour or two to pound a little harder on the left. When you haven’t been able to complete a sentence for days, but that’s just fine as you can’t leave your house to find any humans to talk to and you wouldn’t be able to find your way back home anyway. When you know, you just know that there’s one last zomig in the house if only you could find it. And then you do.
Joan Didion wrote that she came to regard her enemy, migraine, as a friend. Susan Sontag pointed out that describing illness with military metaphors has certain failings, not the least of which is to make ill people feel defeated. I don’t hold with making an ally of migraine, but I will grant you that the first day after the enemy decamps is a Red Letter Day. Today I am so full of vim and vigour that it seems a shame to waste all that energy on work. (Sadly I have so much to catch up on, I’ll have to.) The world is a bright, clear and shiny place today, even if my 401(k) is worth 53% less than what I’ve spent on it. So be it. Feeling like this, I could work until I’m 106, rather like that cheery nun who hasn’t cast a vote since Eisenhower, and who’s thrown her veil in the ring for Obama.
To business; why are triptans so expensive? Fair enough that nobody knows whether migraines are caused by bad chemistry or bad wiring. (Presumably it all looks the same at the molecular level.) So we’re not quite sure why triptans work so well for some people. But when they work, they are transformative within minutes. In Belgium, a month’s supply used to cost me about $100. Here in the US, my gold-plated insurer gives them to me more or less free. But someone’s making a lot of money either way, and migraine has such a huge impact on productivity/absenteeism that getting the cure for cheap would help hundreds of thousands of people and their employers. When did we invent this miracle drug, and will we be sharing the bounty any time soon?
