Direct Cost Burden Among Insured US Employees With Migraine
Direct Cost Burden Among Insured US Employees With Migraine
Objective: To provide a current estimate of the national direct health-care cost burden of illness associated with migraine among a US insured population.
Background: Individuals with migraine use health-care resources more than those without migraine, incurring substantial costs to US employers.
Methods: 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.
Results: 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.
Conclusions: 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.
Approximately 11% of adult Americans suffer from migraine, a disabling neurologic disorder. Migraine is far more common in women, with about 18% of women and 6% of men affected. Migraine prevalence is highest during the peak productive ages of 25 to 55 years, resulting in a high cost to managed care organizations and employers. Individuals with migraine use health-care resources more than those without migraine, with comorbid conditions accounting for a significant portion of the costs. In addition, individuals with migraine file almost twice as many overall medical claims and 2.5 times as many pharmaceutical claims as those without migraine and have more physician office and emergency department (ED) visits.
Using 1994 MEDSTAT data, Hu et al estimated the economic burden of migraine at $14 billion ($17.7 billion in 2004 dollars), with $1 billion in direct medical care ($1.3 billion in 2004 dollars) and $13 billion ($16.5 billion in 2004 dollars) in indirect costs related to lost productivity. Estimates from the 1990s are based on the dollar values, disease management practices, and health services research methodologies of that period and may not reflect the current burden of migraine. The aim of this analysis was to provide more up-to-date estimates of the direct incremental costs associated with employees with migraine compared with those without migraine.
Objective: To provide a current estimate of the national direct health-care cost burden of illness associated with migraine among a US insured population.
Background: Individuals with migraine use health-care resources more than those without migraine, incurring substantial costs to US employers.
Methods: 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.
Results: 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.
Conclusions: 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.
Approximately 11% of adult Americans suffer from migraine, a disabling neurologic disorder. Migraine is far more common in women, with about 18% of women and 6% of men affected. Migraine prevalence is highest during the peak productive ages of 25 to 55 years, resulting in a high cost to managed care organizations and employers. Individuals with migraine use health-care resources more than those without migraine, with comorbid conditions accounting for a significant portion of the costs. In addition, individuals with migraine file almost twice as many overall medical claims and 2.5 times as many pharmaceutical claims as those without migraine and have more physician office and emergency department (ED) visits.
Using 1994 MEDSTAT data, Hu et al estimated the economic burden of migraine at $14 billion ($17.7 billion in 2004 dollars), with $1 billion in direct medical care ($1.3 billion in 2004 dollars) and $13 billion ($16.5 billion in 2004 dollars) in indirect costs related to lost productivity. Estimates from the 1990s are based on the dollar values, disease management practices, and health services research methodologies of that period and may not reflect the current burden of migraine. The aim of this analysis was to provide more up-to-date estimates of the direct incremental costs associated with employees with migraine compared with those without migraine.
Source...