Researchers find that migraine imposes substantial economic burden in US

Not surprisingly, researchers have found that migraine patients have higher direct and indirect health-care costs than those without migraine. They published their results in Headache: The Journal of Head and Face Pain.

“Results from this real-world assessment of the economic burden of migraine suggest that migraine imposes a substantial direct and indirect cost burden in the United States,” noted the authors, led by Machaon Bonafede, PhD, MPH, Truven Health Analytics, Cambridge, MA.

With a large, nationally representative sample of commercially insured patients in the United States, Dr. Bonafede and colleagues sought to give a contemporary estimate of the burden of migraine by calculating both direct and indirect costs, and to compare the health-care costs of migraine patients with a matched group of patients without migraine.

The researchers enrolled patients within the Truven Health Market Scan Research Databases from January 2008-June 2013 into the retrospective, observational study. They matched 71,742 migraine patients 1:1 to patients without migraine for demographics and index date. Migraine patients were categorized into three groups:

• Patients taking either acute or preventive medications (n=45,632);
• Patients taking both acute and preventive medications (n=14,941); and
• Patients who were not treated (n=11,169).

During a 12-month follow-up period, researchers calculated direct health-care use and costs and indirect costs between patients with and without migraine.

Annual direct plus indirect costs in migraine patients were $8,924 higher compared with those without migraine, mean annual direct all-cause health-care costs were $6,575 higher ($11,010 vs $4436, respectively; P < 0.01), as were total mean annual indirect costs by $2,350 ($11,294 vs $8,945).

Researchers also found that migraine patients were twice as likely to use opioids than those without migraines (45.5% vs 21.9%, respectively; P < 0.01). In patients treated with opioids, migraine patients received 1.8 times the number of prescriptions per patients than those without migraine (4.9 vs 2.7; P < 0.01).

Upon adjustment for baseline demographics and clinical characteristics, researchers found that the 16.0% of migraine patients treated with either acute or preventive migraine medications were significantly less likely to have short-term disability claims than untreated patients. In contrast, 20.6% of those treated with both acute and preventive migraine medications and 14.4% of untreated migraine patients had short-term disability.

Despite this, migraine patients had 1.94 times the odds of having a short-term disability claim compared with their matched counterparts without migraine (16.7% vs 6.7%; 95% CI: 1.83-2.05; P < 0.01).

“Compared to matched nonmigraine patients, migraine patients were more likely to have work loss and longer periods of work loss, leading to significantly higher indirect costs. Migraine patients also had higher levels of health-care utilization, despite the relatively stable prevalence of migraine and the available acute and preventive treatment options for migraine management,” concluded the researchers.

This study was funded by Amgen Inc. and conducted by Truven Health Analytics, an IBM Company, USA.