Migraine and headache medications are used by many people as everyday "foods and beverages." Nationwide, more than 3 billion individual doses of painkillers are taken annually through self-medication alone, an estimated 85% of which are for headaches. In Germany, over 125 million packages of painkillers and migraine medications are dispensed each year (Table 1). Including self-medication, approximately 200 million packages of painkillers were purchased

[1,2].

The graphic illustrates the use of migraine and headache medication in Germany. The widespread prevalence of migraine and headache in the population is particularly evident in the consumption of migraine and headache medication (Source: IMS Health 2009, Göbel 2012)

Table 1. Consumption of headache medication via self-medication and triptans in Germany 2009 (modified from IMS Health 2009)

Packages
(in thousands)		 Single doses (in thousands) Value
(in thousands of €)
Painkillers 125.167,4 3.034.282,6 245.720,2
Triptans 3.925,5 21.481,6 79.079,2

Among the 20 best-selling drugs in Germany in 2009, ten were for the indication of headaches [1,2]. These numbers are increasing annually. The amount of analgesics consumed in Germany each year is enough to theoretically provide over 10 million Germans with a daily, continuous supply of painkillers for an entire year. It is estimated that of the approximately 30,000 dialysis patients, around 20 to 30% became dependent on dialysis due to excessive painkiller consumption. This complication of inadequate pain management alone costs the statutory health insurance system around 300 million euros annually [1,2].

Analgesic use has been steadily increasing in recent years. According to the Techniker Krankenkasse (TK) health insurance company, the prescribed daily doses of painkillers among Saarland residents with statutory health insurance rose by 22 percent within five years. This is based on a comparison between the first half of 2009 and the same period in 2004. Sales of painkillers in pharmacies increased by 33 percent during these five years. According to a recent analysis by the German Institute for Drug Testing (DAPI), the consumption of painkillers in Germany has jumped by 50 percent in recent years. While 4.2 million packages were prescribed to patients with statutory health insurance in 2005, this number rose to 6.3 million packages by 2011. Sales of over-the-counter painkillers in Germany amounted to approximately €1.1 billion in 2011. It is estimated that around 2,000 people die annually in Germany from side effects of over-the-counter painkillers [3,4]. On average, every German swallows 37 single doses of painkillers per year (see figure). 8.3 million Germans take an average of one headache tablet per day via self-medication. An average of 58,853 single doses of triptans are taken daily in Germany. Around 60% of the population regularly takes headache medication via self-medication each month. Approximately 12% of the population uses headache medication on more than 10 days per month. Around 3% of the population takes migraine and pain medication daily [1,2].

Nearly 65% ​​of sufferers do not consult a doctor but treat their headaches independently through self-medication outside the professional medical system. Only about 15% seek medical help for headache treatment. Around 60% primarily seek help for migraines and headaches at a pharmacy [1].

Sources:

  1. Göbel H (2012) Headaches. Springer, Berlin, Heidelberg, New York, London, Paris, Tokyo, Hong Kong, Barcelona, ​​Budapest
  2. Health I (2009) The Pharmaceutical Market in Germany. Statistics on human drug purchases by public pharmacies. DPM, Frankfurt am Main.
  3. Kieble M (2012) 6.3 million packages of controlled painkillers were dispensed in 2011. German Drug Testing Institute (DAPI), Berlin
  4. Spiegel Online (2012) Pharmaceutical boom: Germans are swallowing more and more painkillers. http://www.spiegel.de/gesundheit/diagnose/schmerzmittel-aerzte-verschreiben-so-viele-packungen-wie-nie-a-865022.html