Direct Cost Burden Among Insured US Employees With Migraine

Authors

  • Kevin Hawkins PhD,

    1. From the Thomson Medstat, Cambridge, MA, USA (S. Wang); IMS Health, Brooklyn, MI, USA (K. Hawkins); Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ, USA (M. Rupnow).
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  • Sara Wang PhD,

    1. From the Thomson Medstat, Cambridge, MA, USA (S. Wang); IMS Health, Brooklyn, MI, USA (K. Hawkins); Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ, USA (M. Rupnow).
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  • Marcia Rupnow PhD

    1. From the Thomson Medstat, Cambridge, MA, USA (S. Wang); IMS Health, Brooklyn, MI, USA (K. Hawkins); Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ, USA (M. Rupnow).
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  • NOTE: 1994 US$ to 2004 US$ conversions were performed using inflation algorithms from: http://www.dollartimes.com/calculators/inflation.htm

  • Conflict of Interest: Kevin Hawkins was a Senior Health Economist with Thomson Medstat at the time of study execution. Sara Wang is a Senior Statistician/Programmer at Thomson Medstat. Kevin Hawkins and Sara Wang have no affiliation or involvement with for-profit enterprises. Marcia F.T. Rupnow is Director of Outcomes Research at Ortho-McNeil Janssen Scientific Affairs, LLC. This research was supported by Ortho-McNeil Janssen Scientific Affairs, LLC.

Sara Wang, Senior Statistician/Programmer, Thomson Medstat, 150 Cambridge Park Drive, Second Floor, Cambridge, MA 02140, USA.

Abstract

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.

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