Real‐world assessment of the relationship between migraine‐related disability and healthcare costs in the United States

Abstract

Objective The objective of this study was to determine the associations among migraine disability assessment scores, healthcare resource utilization (HCRU; medical visits and pharmacy use) and direct medical costs among people with episodic migraine in a real‐world setting. Background Migraine is a public health concern associated with a substantial economic burden in the United States. However, the association between migraine disability and direct medical costs among people with migraine is unknown. Method This retrospective, cohort study used claims and electronic health record data from the Decision Resources Group database. Adults with migraine with or without aura, defined by International Classification of Disease Revision 9 (ICD‐9) or ICD Revision 10 (ICD‐10) codes, and a completed Migraine Disability Assessment Scale (MIDAS) questionnaire from January 2016 to December 2018 were included (chronic migraine codes not included). The associations of MIDAS score with the cost of HCRU for the 6 months after MIDAS assessment were explored. Results were stratified by treatment setting. Results Among 7662 included patients, MIDAS scores were distributed as: 3348 (43.7%; I, little/none), 1107 (14.4%; II, mild), 1225 (16.0%; III, moderate), 893 (11.7%; IVa, severe), and 1089 (14.2%; IVb, very severe). Worsening disability was associated with higher medical costs (adjusted from a multivariable model). In the primary care setting, healthcare visit costs were $206 (95% confidence interval: $144–294) for grade I and $631 ($384–1036) for grade IVb patients; corresponding pharmacy costs were $203 (grade I; $136–301) and $719 (grade IVb; $410–1259). For specialty care (e.g., neurologist), healthcare visits cost $509 ($411–629) for grade I and $885 ($634–1236) for grade IVb patients; corresponding pharmacy costs were $494 (grade I; $378–645) and $1020 (grade IVb; $643–1620). Conclusion Higher levels of migraine‐related disability (MIDAS assessed) are associated with increased HCRU costs among Americans with episodic migraine. Migraine disability assessment could be useful in the development, testing, and prescription of cost‐effective treatments for people with high migraine‐related disability.

Migraine symptoms, healthcare resources utilization and disease burden in a large Polish migraine cohort

“…It should also be noted that more than 78% of patients who come to work with a headache use only half of their time at work to perform tasks effectively and nearly 25% make mistakes. This constitutes a significantly higher rate of presenteeism compared to other countries, where it averages 35%-43% [ 20 , 24 , 35 , 37 ]. Apart from loss off productivity costs, migraine is also related to a direct economic burden for migraine patients.…”

Konsensusstatement der Migräne- und Kopfschmerzgesellschaften (DMKG, ÖKSG & SKG) zur Therapiedauer der medikamentösen Migräneprophylaxe

“…Während der Großteil der Patienten eine niedrige Attackenfrequenz und niedrige Belastung zeigt, sind 10-20 % der Patienten mit hoher Attackenfrequenz für die hohe Beeinträchtigung und die Belastung des Gesundheitssystems verantwortlich [3]. Patienten mit cM zeigen demzufolge die umfangreichsten Einschränkungen der Alltagsfunktion, lange Zeiten der Arbeitsunfähigkeit und höhere gesundheitsbezogene Kosten [4].…”

Effects of Upper Cervical Spine Manual Therapy on Central Sensitization and Disability in Subjects with Migraine and Neck Pain

“…Migraine is classified as a form of primary headache (3) which affects one in six adults over a 3-month period (4). According to the Global Burden of Disease, migraine is ranked second in the causes of disability (5,6), which is associated with substantial healthcare resource utilization and costs (7). Migraine is an important reason for absenteeism at work or school (8,9).…”

“…Disability can be evaluated using questionnaires and are beneficial in research and clinical settings (20,28). One study revealed the relationship between headache-related disability and healthcare costs (7). Therefore, detailed measurement of disability is important and could be effective in reducing healthcare costs.…”