Quality of Care Measures for Migraine: A Comprehensive Review

Gagne, Joshua J.; Leas, Brian F; Lofland, Jennifer H.; Goldfarb, Neil I.; Freitag, Frederick G.; Silberstein, Stephen D.

doi:10.1089/dis.2007.103639

Cited by 9 publications

(9 citation statements)

References 41 publications

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“…[2,40,41] For example, in a prospective, observational migraine management programme, a total of 789 patients completed MTAQ evaluations at baseline and after a relevant period of follow-up. [40] In this group of patients, statistically significant improvements were noted in various aspects of disease management, such as dissatisfaction with treatment, economic burden, high migraine attack frequency, patient knowledge/behaviour barriers and poor symptom control.…”

Section: Migraine Prophylaxis and Resource Utilizationmentioning

confidence: 99%

“…[1,2] In the US, it is estimated that almost 30 million people, most frequently aged 25-55 years, experience migraine headaches: that is, approximately 5-9% of men and 17-25% of women have debilitating migraines. [1,3] Patients with migraine are estimated to lose a mean of up to 7 work days each year, thus giving an annual total work day loss of approximately 65-150 million days.…”

Section: Introductionmentioning

confidence: 99%

“…[1,3] Patients with migraine are estimated to lose a mean of up to 7 work days each year, thus giving an annual total work day loss of approximately 65-150 million days. [2][3][4] Furthermore, the annual direct costs of migraine (including visits to physicians, or urgent or emergency centres, diagnostic tests, treatments and hospitalizations) have been estimated at $US1.25-11.1 billion, and indirect costs resulting from reduced productivity alone have been reported in the range of $US16.2-28.7 billion, thus giving an estimated annual indirect burden of disease of approximately $US2800 per patient with migraine (2006 costings). [2] These figures are likely to be an underestimate, as migraine is often undiagnosed and untreated.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] Furthermore, the annual direct costs of migraine (including visits to physicians, or urgent or emergency centres, diagnostic tests, treatments and hospitalizations) have been estimated at $US1.25-11.1 billion, and indirect costs resulting from reduced productivity alone have been reported in the range of $US16.2-28.7 billion, thus giving an estimated annual indirect burden of disease of approximately $US2800 per patient with migraine (2006 costings). [2] These figures are likely to be an underestimate, as migraine is often undiagnosed and untreated. [1,3,5] Thus, it is clear that migraine headache presents a huge economic burden for patients, employers, health systems and society.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Migraine Prophylaxis on Migraine-Related Resource Use and Productivity

Láinez

2009

CNS Drugs

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In the US, it is estimated that up to 10% of men and 25% of women, particularly those aged 25-55 years, experience debilitating migraines, such that the condition presents an enormous economic burden for patients, health systems, employers and society. Migraine headache is a particularly prevalent condition associated with major reductions in patients' quality of life. From a payer perspective, the implementation of relevant programmes of migraine prophylaxis is highly desirable. Consistent evidence exists, from several randomized, controlled studies, of the efficacy of amitriptyline, divalproex sodium, propranolol, timolol and topiramate in migraine prophylaxis. Considering resource utilization, various studies suggest that migraine prophylaxis with antiepileptics, antidepressants, beta-blockers or calcium channel antagonists markedly reduces triptan use and visits to physician offices and emergency departments (EDs), without compromising quality of care or treatment outcomes. Over recent years, the effects of topiramate in reducing resource utilization in patients with migraine have been relatively widely studied. In US claims database analyses involving >4000 patients with migraine, topiramate significantly reduced triptan use by up to 20% in the 12-month period after starting treatment. Reductions were also noted in the numbers of ED visits, diagnostic procedures, hospital admissions and migraine-related hospitalization days. These long-term benefits of topiramate manifested without any increase in overall headache-related costs. Furthermore, in detailed modelling analyses based on UK and US data, topiramate-induced savings in acute medical services were estimated to offset about one-quarter of the monthly per patient cost of the topiramate regimen, which was shown to be a dominant cost-effective intervention relative to no preventive therapy: cost-effectiveness ratios were calculated as pound 5728 per quality-adjusted life-year (QALY) [2005 costings] and $US10 888 per QALY (2002 costings), respectively. Overall, there is a need to improve quality of care in migraine, and prophylactic therapy appears to be an effective option, particularly with respect to decreasing resource use and improving productivity. For both health-plan payers and employers, topiramate appears to be a cost-effective intervention for preventing migraine.

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Section: Migraine Prophylaxis and Resource Utilizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Migraine Prophylaxis on Migraine-Related Resource Use and Productivity

Láinez

2009

CNS Drugs

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“…Gagne et al [9], in a study aimed at drawing a comprehensive review for quality of care measures, stress how no standardized measures for measuring quality of life for patients suffering from migraine have been developed so far. For example, the Health Plan Employer Data and Information Set, maintained by the National Committee for Quality Assurance is widely used in the US to assess quality of care at the health-plan level, but it does not include any headache, or migraine-related measures.…”

Section: Migraine and Quality Of Lifementioning

confidence: 99%

Improving care through health economics analyses: cost of illness and headache

2008

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The impact of headache disorders is a problem of enormous proportions, both for individual and society. The medical literature tried to assess its effects on individuals, by examining prevalence, distribution, attack frequency and duration, and headache-related disability, as well as effects on society, looking at the socio-economic burden of headache disorders [Rasmussen (Cephalalgia 19:20–23, 1999)]; [Lanteri-Minet et al. (Pain 102:143–149, 2003)]. The issue of costs represents an important problem too, concerning both direct and indirect costs. Direct costs concern mainly expenses for drugs. Migraine has a considerable impact on functional capacity, resulting in disrupted work and social activities: many migraineurs do not seek medical attention because they have not been accurately diagnosed by a physician or do not use prescribed medication [Solomon and Price (Pharmacoeconomics 11:1–10, 1997)]. Indirect costs associated with reduced productivity represent a substantial proportion of the total cost of migraine as well. Migraine has a major impact on the working sector of the population, and therefore, determining the indirect costs outweighs the direct costs. This study will explain the notion of cost of illness, examining how it could be applied in such a framework. Then, an overview of the studies aimed at measuring direct and indirect costs of migraine and headache disorders will be carried out, later shifting on to the relationship between costs and quality of life for people affected by headache disorders. Finally, a brief review on advantages of new pharmaceuticals and preventive treatments for migraine for patients and society will outline improvements in the context of cost-effectiveness and cost-utility analysis.

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