Economic benefits of treating medication-overuse headache – results from the multicenter COMOESTAS project

Abstract

Background Medication-overuse headache is a costly disease for individuals and society. Objective To estimate the impact of medication-overuse headache treatment on direct and indirect headache-related health care costs. Methods This prospective longitudinal study was part of the COMOESTAS project (COntinuous MOnitoring of Medication Overuse Headache in Europe and Latin America: development and STAndardization of an Alert and decision support System). Patients with medication-overuse headache were included from four European and two Latin American headache centers. Costs of acute medication, costs of health care services, and measurements of productivity were calculated at baseline and at 6-month follow-up Treatment consisted of overused drug withdrawal with optional preventive medication. Results A total of 475 patients (71%) completed treatment and were followed up for 6 months. Direct health care costs were on average reduced significantly by 52% ( p < 0.001) for the total study population. Significant reductions were seen in both number of consumed tablets (-71%, p < 0.001) and number of visits to physicians (-43%, p < 0.001). Fifty percent of patients reduced their number of consumed tablets ≥ 80%. Headache-related productivity loss, calculated either as absence from work or ≥ 50% reduction of productivity during the workday, were reduced by 21% and 34%, respectively ( p < 0.001). Conclusion Standardized treatment of medication-overuse headache in six countries significantly reduced direct health care costs and increased productivity. This emphasizes the importance of increasing awareness of the value of treating medication-overuse headache. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056).

The Many Faces of Medication‐Overuse Headache in Clinical Practice

“…In terms of economic impact, the COMOESTAS study looked at the potential beneficial effects of the treatment of MOH. A significant reduction in both direct healthcare costs (52%) and increase in productivity cutting indirect costs (21% less absenteeism) was observed 168 . The end points, definitions and study designs of different trials are heterogeneous, and therefore, difficult to compare.…”

The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data

“…To our knowledge, only the study by Shah et al . and COMOESTAS addressed longitudinal cost reduction in MOH patients . However, both studies addressed healthcare costs only, thus providing partial information.…”

“…Secondly, our study is the first to demonstrate the cost-effectiveness of a structured treatment protocol, either in day-hospital or in a ward setting. To our knowledge, only the study by Shah et al and COMOESTAS addressed longitudinal cost reduction in MOH patients [7,9]. However, both studies addressed healthcare costs only, thus providing partial information.…”

“…only direct or only indirect costs) and on diagnostic groups, i.e. episodic and/or chronic headaches [6][7][8][9][10][11][12][13]. Four recent studies specifically evaluated the cost of MOH.…”

“…In sum, the cost of MOH has not been assessed in a comprehensive way, and it is likely to be underestimated: in fact, preliminary data referred to the sample included here enabled a per-person annual cost higher than €10 000 to be hypothesized [10]. Furthermore, only a Danish study and COMOESTAS [7,9] evaluated the cost reduction after a structured withdrawal treatment. The aim of this study was two-fold: to address the cost-effectiveness of our structured protocol and to present 1-year MOH cost estimates for Italy based on real-life data.…”