United States Patients’ Perspective of Living With Migraine: Country‐Specific Results From the Global “My Migraine Voice” Survey

Abstract

Background.-Migraine is associated with debilitating symptoms that can affect daily functioning. "My Migraine Voice" was a large, cross-sectional, multi-country online survey aimed at understanding disease burden directly from people with migraine. Objective.-This study reports on the social and economic impacts of migraine, specifically the impact on activities of daily living and the costs of migraine, from the point of view of people with migraine in the United States. Methods.-The online survey was administered to adults with a self-reported diagnosis of migraine who experienced 4 or more monthly migraine days each month for the previous 3 months. Prespecified screening quotas were used so that 90% of respondents reported current or past use of preventive migraine medication, 80% of whom switched treatment (ie, changed their prescribed preventive medication at least once). The remaining 10% were preventive treatment naïve (ie, never used any prescribed preventive medication). Burden of migraine on activities of daily living and caregivers (eg, functional limitations, fear of next migraine attack, sleep problems) and economic burden (eg, out-of-pocket costs, impact on work productivity using the validated work productivity and activity impairment questionnaire) reported by respondents from the United States are presented. Results are stratified by employment status, migraine frequency (chronic vs episodic migraine), and history of preventive treatment. Results.-Thousand hundred and one individuals with migraine from the United States responded to the survey. Respondents reported limitations completing daily activities during all migraine phases, including during the premonitory/aura and postdrome phases. Most (761/1101 (69%)) relied on family, friends, or others for help with daily tasks and reported being helped a median of 9 days (25th percentile 5 days, 75th percentile 15 days) within the last 3 months. Respondents with chronic migraine reported being helped for more days (median 10 days, 25th percentile 5 days, 75th percentile 23 days) in the last 3 months. Almost all (962/1101 (87%)) experienced sleep difficulties and 41% (448/1101) (48% (336/697) of those with 2 or more preventive treatment failures) were very or extremely fearful of a next migraine attack. Median (25th percentile, 75th percentile) monthly

Identifying Outcome Measures for Migraine Value‐Based Contracting Using the Delphi Method

“…39 Employer stakeholders were additionally given equal weight due to the impact migraine has on work performance outcomes. 2,[11][12][13][14][15][16] Since migraine is a common presentation in both primary care and neurology clinics, we asked that both PCPs and neurologists contribute their expertise on the panel. While there is wide variation in the number of participants that serve on Delphi panels in the literature, our Delphi panel size was larger than, or similar to, typical reported Delphi studies.…”

“…1 1010 405 223 301 (10) 10 488 (44) 26 (29) 16 (20) Decrease in emergency department/urgent care visits ¶, † † 0 (0) 0 (0) 1 (10) 1 105 204 175 503 (30) 5 244 2216 (18) 12 (15) Decrease in need for abortive/rescue medications "decrease in migraine frequency" as the 2 most feasibly collected migraine outcomes, with 95% (40/42) and 90% (38/42) agreement in the consensus round, respectively (Table 3). Panelists also reached consensus on a third outcome, "decrease in need for abortive/rescue medications," at 76% agreement (32/42).…”

“…2,[11][12][13][14][15][16] Migraine leads to increased work-related disability, increased presenteeism (exhibiting reduced performance while physically present at work) and absenteeism (missing work due to illness). 2,[11][12][13][14][15][16] A recent analysis from the global "My Migraine Voice" survey reported that migraine caused 22% absenteeism, 60% presenteeism, 65% work productivity loss, and 64% activity impairment among respondents in the United States. 15 Accordingly, migraine has been shown to be one of the costliest health conditions for employers.…”

“…2,[11][12][13][14][15][16] A recent analysis from the global "My Migraine Voice" survey reported that migraine caused 22% absenteeism, 60% presenteeism, 65% work productivity loss, and 64% activity impairment among respondents in the United States. 15 Accordingly, migraine has been shown to be one of the costliest health conditions for employers. 2,[11][12][13][14][15][16] Although many prescription acute and preventive migraine treatments exist, the socioeconomic burden of migraine continues to rise.…”

“…2,[11][12][13][14][15][16] Although many prescription acute and preventive migraine treatments exist, the socioeconomic burden of migraine continues to rise. 2,[11][12][13][14][15][16] The direct (ie, measurable health care expenses) and indirect (ie, decrease in work productivity) annual combined costs of migraine are $56.31 billion in the United States alone. 11 As the US health care system shifts toward value-driven care, there is opportunity to create value-based payment arrangements for conditions that impose significant clinical, societal, and financial burden.…”