Costs of Acute Headache Medication Use and Productivity Losses Among Patients with Migraine: Insights from Three Randomized Controlled Trials

Abstract

Background Migraine is associated with a substantial physical and emotional burden for patients. There is also a large economic burden associated with migraine, in terms of lost productivity and healthcare resource use. By reducing the number of monthly migraine days (MMD) experienced by patients, effective preventive treatments can reduce acute medication use and costs of lost productivity. Methods Patient level data from three erenumab clinical trials (NCT02456740, NCT02483585 and NCT02066415) were combined and migraine day frequencies were examined. The number of days per month on which patients used acute medication was estimated as a function of MMD. Productivity losses were estimated based on patient responses to the Migraine Disability Assessment questionnaire. Zero-inflated Poisson regression models were used to predict acute medication use and productivity losses per MMD. Results The results demonstrated that as MMD increased, use of acute medication also increased. Similarly, as MMD increased, loss of productivity (due to absenteeism and presenteeism) also increased. The relationship of MMD to both acute headache medication use and lost productivity was non-linear, with marginal outcomes increasing with frequency. Conclusions As MMD increased, acute medication use and productivity loss also increased, but the relationship was non-linear. Therefore, it is important that the distribution of MMD patients is accounted for when estimating the outcomes of migraine patients. By reducing the MMD experienced by patients, effective preventive agents may reduce the requirement for acute medication and also reduce productivity loss, which may translate into potential economic savings. Electronic supplementary material The online version of this article (10.1007/s41669-018-0105-0) contains supplementary material, which is available to authorized users.

Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

“…5 A more recent study, that included patient-level data from the three North American and European populations, could demonstrate that a relationship between the number of monthly migraine days and the use of acute medication as well as the loss of productivity (due to absenteeism) exists; however, this relationship was not linear. 4 Additionally, our findings could show that triptan users had continuously lower mean and median costs in all investigated subgroups than nontriptan users. However, there was one exception among the age group >64 years.…”

“…However, prior epidemiologic studies emphasize the association of migraine with diverse comorbid conditions, which consequently also results in an even higher economic impact of migraine, especially when considering the indirect costs of productivity losses. 3,4 Linde and colleagues, for example, reported in their study mean annual perperson costs of EUR 1222 (US Dollars 1634) for migraine (95% CI 1055-1389; indirect costs 93%). 5 A more recent study, that included patient-level data from the three North American and European populations, could demonstrate that a relationship between the number of monthly migraine days and the use of acute medication as well as the loss of productivity (due to absenteeism) exists; however, this relationship was not linear.…”

“…A direct comparison of this amount with estimates from other European studies seems to be difficult since most findings are based on the cost‐of‐illness analyses including direct and indirect costs (including productivity losses). However, prior epidemiologic studies emphasize the association of migraine with diverse comorbid conditions, which consequently also results in an even higher economic impact of migraine, especially when considering the indirect costs of productivity losses . Linde and colleagues, for example, reported in their study mean annual per‐person costs of EUR 1222 (US Dollars 1634) for migraine (95% CI 1055‐1389; indirect costs 93%) .…”

“…Epidemiological studies have shown that patients with migraine were five times more likely to have comorbid conditions than their controls . Moreover, besides the clinical burden of migraine, headache attacks have also economic consequences including indirect costs incurred due to its complications and productivity losses . In Europe, the economic cost of migraine is estimated at Euro 111 billion per year, whereby the mean annual costs per person amounted to Euro 1222 …”

“…costs incurred due to its complications and productivity losses. 3,4 In Europe, the economic cost of migraine is estimated at Euro 111 billion per year, whereby the mean annual costs per person amounted to Euro 1222. 5 Therapeutic management of patients with migraine consists of the treatment of acute attacks and prophylaxis, according to evidence-based recommendations.…”