The annual cost of migraine
In Europe, the annual cost of migraine was estimated to be €50–111 billion in 2011,1 said Professor Massoud Ashina, Copenhagen, Denmark. Indirect costs resulting from work absenteeism and reduced work productivity accounted for 93%, while direct costs (ie, healthcare resource utilization) accounted for 7%.1
Healthcare resource utilization accounts for only 7% of the overall cost of migraine
The direct costs of migraine
The direct costs of migraine are medications, physician consulting services, emergency department visits, investigations, and management of treatment adverse events,1 explained Professor Paolo Martelletti, Rome, Italy.
32% of 420 Italians with at least 4 monthly migraine days and at least two preventive treatment failures had at least one emergency room visit in the previous 12 months
To investigate the healthcare resource utilization further, Professor Martelletti and his colleagues analysed data for 420 Italians attending a tertiary level headache center who had at least four monthly migraine days and at least two preventive treatment failures.2 They found that in the previous 6 months:
- 58% of the patients had visited general practitioners (mean number of visits [MNV] 4.5)
- 32% had visited neurologists (MNV 2.6)
- 26% had visited headache specialists (MNV 2.8)
In the previous 12 months, 32% had at least one emergency room visit (MNV 2.8) and 15% had at least one hospitalization (MNV 2.9) because of migraine.2
Direct costs are higher in patients with chronic migraine than in those with episodic migraine
The direct costs have been further evaluated by a retrospective, noninterventional observational analysis of electronic medical records of patients with episodic migraine (EM) and chronic migraine (CM) undergoing continuous treatment for 2 years in Rome,3 said Professor Martelletti. They were found to be 4.8 times higher for patients with CM than for patients with EM, were significantly higher for women than for men, and increased with age.3
Effective preventive medication significantly lowers use of healthcare resources
Earlier use of effective treatments to prevent chronification lowers direct costs4
Use of healthcare resources is significantly lower for patients treated with effective preventive medication than for patients with stable or worsened migraine,4 said Professor Martelletti.
In addition, structured headache services based in primary care with provider training and consumer education have been shown to be cost-effective.5
Many patients are receiving inadequate treatment for migraine7
However, many patients with migraine are waiting years for referral to appropriate specialists,6 said Professor Raquel Gil-Gouveia, Lisbon, Portugal, and many patients with migraine are receiving inadequate treatment for migraine, even in wealthy European countries.7
This satellite symposium was supported by Novartis.