Direct cost burden among insured US employees with migraine.
ABSTRACT To provide a current estimate of the national direct health-care cost burden of illness associated with migraine among a US insured population.
Individuals with migraine use health-care resources more than those without migraine, incurring substantial costs to US employers.
The Thomson Medstat's Commercial Claims and Encounters 2004 database was utilized for this study. Only paid claims were analyzed. The migraine cohort had a primary migraine diagnosis and/or a migraine-specific abortive drug prescription during 2004. A matched control cohort with no evidence of migraine was generated using propensity score techniques. Demographic characteristics and overall comorbidities were similar between cohorts. A second-stage regression controlled for any remaining significant intergroup differences. The burden of illness of migraine was defined as the difference in average total health-care expenditures per person between cohorts. The national burden of illness was defined as the average expenditure for migraine of national population estimates of privately insured individuals, and was estimated by projecting the migraine prevalence rate and average expenditure using Medical Expenditure Panel Survey population estimates.
Patients with migraine (n=215,209) had significantly higher average health-care expenditures compared with matched controls ($7007 vs $4436 per person per year; difference of $2571; P<.001). Migraine-associated national expenditure estimates: outpatient care, $5.21 billion; prescriptions, $4.61 billion; inpatient care, $0.73 billion; and emergency department care, $0.52 billion.
The direct costs associated with patients with migraine were found to be $2571 per person per year higher than in matched nonmigraine controls. The projected national burden of migraine of $11.07 billion is substantially higher than previous estimates.
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ABSTRACT: To determine a possible relationship between migraine and body mass index. Migraine shows a wide spectrum of comorbidities, including cardiocerebral, vascular, psychiatric, metabolic, neurological as well as other pathologies. Recent researches suggest that obesity was significantly correlated with migraine frequency and disability in children, as well as in adult population studies. We reviewed data from the literature to clarify this possible relationship. Translational and basic science research shows multiple areas of overlap between migraine pathophysiology and the central and peripheral pathways regulating feeding. Specifically, neurotransmittors such as serotonin, peptides such as orexin, and adipocytokines such as adiponectin and leptin have been suggested to have roles in both feeding and migraine. A relationship between migraine and body mass index exists, and therefore, interventions to modify body mass index may provide a useful treatment model for investigating whether modest weight loss reduces headache frequency and severity in obese migraineurs. The effect of obesity and weight change on headache outcomes may have important implications for clinical care.Acta Paediatrica 07/2012; 101(9):e416-21. · 2.07 Impact Factor
Article: Sumatriptan transdermal iontophoretic patch (NP101-Zelrix™): review of pharmacology, clinical efficacy, and safety in the acute treatment of migraine.[show abstract] [hide abstract]
ABSTRACT: Migraine is a chronic, painful, and often disabling primary headache disorder, typically presenting with recurrent attacks that may be accompanied by a variety of neurological, gastrointestinal, and autonomic symptoms. Gastrointestinal symptoms in association with migraine including, nausea, vomiting, and gastroparesis, affect a large proportion of migraine sufferers. These symptoms may result in delays or inconsistencies in the absorption of oral treatments. Hence, the necessity for an innovative, non-invasive, parenteral delivery formulation for quick and effective treatment of migraine attacks is evident. Iontophoresis utilizes minimal amounts of electrical potential to support the fast transfer of ionized medication transdermally and into the general circulation. Two pharmacokinetic clinical trials have shown that iontophoretic delivery of sumatriptan through the skin produces quick and reproducible therapeutic plasma concentrations. A randomized, double-blind, multicenter, phase III study demonstrated superior efficacy versus placebo and excellent tolerability, with no triptan-related adverse events. The proportion of patients that were pain-free at 2 h post-treatment was 18% for the sumatriptan patch vs 9% for placebo (P = 0.0092; number needed to treat = 11.1). Upon approval from the Food and Drug Administration and other regulatory authorities, the iontophoretic transdermal delivery of sumatriptan will be a good choice for patients experiencing poor absorption of oral medication often associated with migraine and/or for those with intolerable triptan-related adverse events.Neuropsychiatric Disease and Treatment 01/2012; 8:429-34. · 1.81 Impact Factor
Article: Cost of Health Care Among Patients With Chronic and Episodic Migraine in Canada and the USA: Results From the International Burden of Migraine Study (IBMS)[show abstract] [hide abstract]
ABSTRACT: (Headache 2011;51:1058-1077)Objective.— To evaluate and compare healthcare resource use and related costs in chronic migraine and episodic migraine in the USA and Canada.Background.— Migraine is a common neurological disorder that produces substantial disability for sufferers around the world. Several studies have quantified overall costs associated with migraine in general, with recent estimates ranging from $581 to $7089 per year. Although prior studies have characterized the clinical and humanistic burden of chronic migraine relative to episodic migraine, to the best of our knowledge only 1 previous study has compared chronic migraine and episodic migraine healthcare costs. The purpose of this study was to quantify and compare the direct medical costs of chronic migraine and episodic migraine using medical resource use data collected as part of the International Burden of Migraine Study.Methods.— Cross-sectional data were collected from respondents in 10 countries via a Web-based survey. Respondents were classified as chronic migraine (≥15 headache days/month) or episodic migraine (<15 headache days/month). Data collection included socio-demographic and clinical characteristics and medical resource use for headache (clinician and emergency department visits and hospitalizations over the preceding 3 months and medications over the preceding 4 weeks). Unit cost data were collected outside of the Web-based survey using publicly available sources and then applied to resource use profiles. Cost estimates are presented in 2010 US and Canadian dollars.Results.— In this manuscript, the analysis included data from respondents with migraine in the USA (N = 1204) and Canada (N = 681). The most common medical services utilized by all respondents included headache-specific medication, healthcare provider visits, emergency department visits, and diagnostic testing. In the USA, approximately one-quarter (26.2%) of chronic migraine participants vs 13.9% of episodic migraine participants reported visiting a primary care physician in the preceding 3 months (P < .001). In Canada, one-half (48.2%) of chronic migraine participants had a primary care physician visit, compared with 12.3% of episodic migraine subjects (P < .0001). Total mean headache-related costs for participants with chronic migraine in the USA were $1036 (±$1334) over 3 months compared to $383 (±807, P < .001) for persons with episodic migraine. In Canada, total mean headache-related costs among chronic migraine subjects were $471 (±1022) compared to $172 (±920, P < .001) for episodic migraine subjects.Conclusions.— Chronic migraine was associated with higher medical resource use and total costs compared to episodic migraine. Therapies that reduce headache frequency could become important approaches for containing or reducing headache-related medical costs.Headache The Journal of Head and Face Pain 07/2011; 51(7):1058 - 1077. · 2.52 Impact Factor