Factors Associated with Direct Health Care Costs Among Patients with Migraine

Bonafede, Machaon; Cai, Qing; Cappell, Katherine; Kim, Gilwan; Sapra, Sandhya; Shah, Neel; Widnell, Katherine L.; Winner, Paul; Desai, Pooja

doi:10.18553/jmcp.2017.23.11.1169

Cited by 25 publications

(30 citation statements)

References 42 publications

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“…In one example of such a study, in an analysis of the same dataset presented here, a strong association between high triptan and opioid use and being in the top quartile of direct, all-cause healthcare costs was demonstrated. 38 Finally, research on the impact of treatment adherence on healthcare utilization and costs would be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States

et al. 2018

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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. 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 healthcare utilization, despite the relatively stable prevalence of migraine and the available acute and preventive treatment options for migraine management.

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Section: Discussionmentioning

confidence: 99%

Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States

et al. 2018

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“…An estimated $11 billion in direct costs and $12 billion in indirect costs are attributable to migraine annually in the United States (US). In addition, a recent retrospective database analysis estimated that individuals with migraine incur, on average, $13,000 in direct health care costs annually . Moreover, migraine is often undertreated, which may lead to an increase in the use of health care resources (eg, emergency department visits and opioid use) …”

Section: Introductionmentioning

confidence: 99%

“…In addition, a recent retrospective database analysis estimated that individuals with migraine incur, on average, $13,000 in direct health care costs annually. [3][4][5] Moreover, migraine is often undertreated, which may lead to an increase in the use of health care resources (eg, emergency department visits and opioid use). 6 There are unmet needs with currently available treatment options for migraine.…”

Section: Introductionmentioning

confidence: 99%

Patient Preferences for Preventive Migraine Treatments: A Discrete‐Choice Experiment

et al. 2019

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Objective To understand treatment preferences of people with migraine and the relative importance of improvements in efficacy and avoiding adverse events (AEs), such as cognition problems or weight gain. Background Current preventive migraine medicines are associated with poor adherence and tolerability. There is an unmet need for effective migraine‐specific preventive treatments with fewer AEs. Methods In a web‐based discrete‐choice experiment survey, respondents who self‐reported having ≥6 migraine days/month were offered choices between pairs of hypothetical preventive migraine medicines. Six attributes, each with 3 levels, defined the medicines: reduction in headache days per month (10%, 25%, or 50%), frequency of limitations with physical activities (none, 1‐category improvement, or 2‐category improvement), cognition problems (no problems, thinking problems, or memory problems), weight gain (none, 5% body weight gain, or 10% body weight gain), how the medicine is taken (daily oral pill, once‐monthly injection, or twice‐monthly injection), and monthly out‐of‐pocket cost ($5, $60, or $175). The attributes and levels were informed by clinician input, the clinical literature, and 2 focus groups. An experimental design was used to create the pairs of hypothetical medicines for the discrete‐choice experiment questions. Random‐parameters logit was used to estimate the relative importance of the medicine attributes, and the results were used to predict the percentage of respondents who would select one medicine profile over another and to calculate willingness to pay for changes in attribute levels. Results The sample included 300 respondents; 72% indicated that migraines make physical activities difficult all or most of the time, and 81% had taken a prescription medicine to prevent migraine in the last 6 months. Respondents reported having, on average, approximately 16 headache days per month. Among noncost attributes, respondents valued a change from a 10% reduction in migraine days to a 50% reduction more highly than avoiding the worst levels of AEs, but were willing to trade off efficacy for less‐severe AEs. Avoiding memory problems was more important than avoiding thinking problems. Avoiding a 10% weight gain was more important than avoiding thinking and memory problems. Respondents preferred a once‐monthly injection or daily pill to twice‐monthly injection. Respondents, on average, were willing to pay $84 (95% confidence interval [CI], $64‐$103) per month to avoid a 10% weight gain, $59 (95% CI, $42‐$76) per month to avoid memory problems, $35 (95% CI, $20‐$51) per month to avoid a 5% weight gain, and $32 (95% CI, $18‐$46) per month to avoid thinking problems. Conclusions A preventive migraine medicine with improved efficacy and AE profile and a favorable mode of administration would be valuable to migraine sufferers. Patients may be willing to trade off efficacy for better AE profiles. Clinicians should work with patients to select treatments that meet each patient’s needs.

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“…Further, as the result of the combined disability, depression and anxiety is likely to affect healthcare costs and utilization [9,10]. Migraine is one of the most expensive chronic conditions, with an estimated annual cost of $17 billion in the U.S. alone [11].…”

Section: Introductionmentioning

confidence: 99%

“…Migraine is one of the most expensive chronic conditions, with an estimated annual cost of $17 billion in the U.S. alone [11]. Depression and anxiety among adults with migraine lead to significantly greater healthcare costs [9,10]. Yet, depression and anxiety are unrecognized and untreated in adults with migraine [3].…”

Section: Introductionmentioning

confidence: 99%

Humanistic and Economic Burden of Depression and Anxiety among Adults with Migraine: A systematic review

Alwhaibi¹

2020

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Background Depression and anxiety are highly prevalent disabling chronic conditions among adults with migraine. These comorbid conditions are becoming a well-recognized public health problem in many countries due to their humanistic and economic burden.Objectives This review was conducted to assess systematically the humanistic and financial burden of migraine and depression and/or anxiety disorder among adults with migraine.Methods A systematic literature search conducted using MedLine and CINAHL via EBSCO, OVID and Cochrane Database of Systematic Reviews via OVID. Studies evaluating the humanistic burden (disability and Health-related Quality of Life (HRQoL)) and the economic burden and healthcare utilization of comorbid depression and anxiety among adults with migraine that were published in peer-reviewed English language journals from inception until August 2019 were included.Results Of the 957 articles identified, 24 studies were included in the review. HRQoL was measured using generic, and migraine-specific measures. Regarding the humanistic burden, twelve studies reported an association between depression and/or anxiety and lower HRQoL and seven studies reported an association between depression and/or anxiety and higher disability. Regarding the economic burden, only two studies were identified and both found that depression and/or anxiety are associated with higher healthcare expenditures and utilization among adults with migraine.Conclusions These results of this review highlight the substantial impact of depression and/or anxiety on HRQoL, disability, healthcare cost and utilization of medical services for adults with migraine. It is important for healthcare providers to be aware of the negative impact of these illnesses and identify and treat anxiety and depression as treatment may have a potential to improve the health outcomes of patients living with migraine.

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Factors Associated with Direct Health Care Costs Among Patients with Migraine

Cited by 25 publications

References 42 publications

Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States

Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States

Patient Preferences for Preventive Migraine Treatments: A Discrete‐Choice Experiment

Humanistic and Economic Burden of Depression and Anxiety among Adults with Migraine: A systematic review

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