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The Burden of Migraine in Spain

Beyond Direct Costs

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Abstract

Objective: To estimate the economic burden of migraine in Spain, from the societal perspective.

Methods: The Spanish 2001 annual direct (pharmacy, primary care, specialist and emergency room visits) and indirect (missed workdays and reduced work performance) costs were calculated using the prevalence approach. The human-capital method was used to calculate indirect costs. The sources used were published epidemiological and resource use studies using the International Headache Society diagnostic criteria from official and unofficial databases.

Results: The Spanish population with migraine was estimated to be 3 617 600 patients, 92.5% being of a working age. The economic burden of migraine was about €1076 million. The direct costs represented only 32.0% of the total burden (€344 million), 39.2% being for primary care visits, 28.7% for specialist visits, 20.5% for emergency room visits and a further 11.7% for migraine-specific prescription drugs (serotonin 5-HT1B/1D receptor agonists [triptans] 10.8%, ergots 0.9%). The indirect cost was estimated at €732 million annually, representing €453.55 per working patient with migraine.

Conclusions: As in many other developed countries, migraine represents a considerable economic burden in Spain, especially in terms of productivity losses. Therefore, activities should be specifically directed at reducing the indirect costs, and effective treatments, which significantly reduce productivity losses, should be publicly promoted.

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References

  1. Ferrari MD, Haan J. Acute treatment of migraine attacks. Curr Opin Neurol 1995; 8: 237–42

    Article  PubMed  CAS  Google Scholar 

  2. Breslau N, Rasmussen BK. The impact of migraine: epiddemiology, risk factors and co-morbidities. Neurology 2001; 56 (6 Suppl. 1): S4–12

    Article  Google Scholar 

  3. Launer LJ, Terwindt GM, Ferrari MD. The prevalence and characteristics of migraine in a population based cohort: the GEM study. Neurology 1999; 53: 537–42

    Article  PubMed  CAS  Google Scholar 

  4. Stewart WF, Lipton RB, Liberman J. Variation in migraine prevalence by race. Neurology 1996; 47: 52–9

    Google Scholar 

  5. van Roijen L, Essink-Bot ML, Koopmanschap MA, et al. Societal perspective on the burden of migraine in The Netherlands.

  6. Meddis D, Sawyer JPC. Health economic outcomes in migraine: impact of zolmitriptan. Rev Contemp Pharmacother 2000; 11: 133–8

    CAS  Google Scholar 

  7. Oliva Moreno J. Valoraci´on de costes indirectos en la evaluaci#x00F3;n sanitaria. Med Clin 2000; 114 Suppl. 3: 15–21

    Google Scholar 

  8. Byford S, Torgerson DJ, Raftery J. Cost of illness studies. BMJ 2000; 320: 1335

    Article  PubMed  CAS  Google Scholar 

  9. Lipton RB, Stewart WF. The epidemiology of migraine. Eur Neurol 1994; 34: 6–11

    Article  PubMed  Google Scholar 

  10. Koopmanschap MA, Rutten FFH. Indirect costs in economic studies: confronting the confusion. Pharmacoeconomics 1993; 4 (6): 446–54

    Article  PubMed  CAS  Google Scholar 

  11. Drummond MF, O’Brien BJ, Scoddard GL, et al. Methods for economic evaluation of health care programmes. 2nd ed. Oxford: Oxford University Press, 1997

    Google Scholar 

  12. Gold MR, Siegel JE, Russell LB, et al. Cost-effectiveness in health and medicine. Oxford: Oxford University Press, 1996

    Google Scholar 

  13. Weisbrod B. Economics of public health. Philadelphia (PA): University of Pennsylvania Press, 1961

    Google Scholar 

  14. Rice DP. Cost of illness studies: fact or fiction? Lancet 1994; 344: 1519–20

    Article  PubMed  CAS  Google Scholar 

  15. Behrens C, Henke KD. Cost of illness studies: an aid to decision-making? Health Policy 1988; 10: 137–41

    Article  PubMed  CAS  Google Scholar 

  16. Shiell A, Gerard K, Donaldson C. Cost of illness studies: an aid to decision-making? Health Policy 1987; 8: 317–23

    Article  Google Scholar 

  17. Murray CJL, Lopez AD, editors. Global comparative assessments in the health sector: disease burden, expenditure and intervention packages. Geneva: World Health Organization, 1994

    Google Scholar 

  18. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988; 8: 1–96

    Article  Google Scholar 

  19. El Mercado Farmaceético (E.M.F.). TAM Diciembre 2001. Madrid: IMS Health, 2001

    Google Scholar 

  20. Base de Datos de Costes Sanitarios Soikos. Barcelona: Soikos, 2001

  21. Lóinez JM. Epidemiología e impacto socioeconómico. In: Pascual J, editor. Migrañña. Barcelona: Masson, 2001: 4–12

  22. Palencia R, Sinovas MI. Prevalence of migraine in a sample population of school children. Rev Neurol 1997; 25: 1879–82

    PubMed  CAS  Google Scholar 

  23. Cifras de población. 31 diciembre 2001. INE, 2002. Available from URL: http://www.ine.es/inebase/cgi/um. [Accessed 2002 May 15]

  24. Estudio de las Prescripciones Médicas (E.P.M.). IV Trimestre 2001. Madrid: IMS Health, 2001

    Google Scholar 

  25. Morera-Guitart J. Estudio transversal multicéntrico del cuidado neurológico en la comunidad autónoma de Valencia. Comisión de Análisis de Calidad de la Sociedad valenciana de Neurología. Rev Neurol 1998; 27: 438–46

    PubMed  CAS  Google Scholar 

  26. Martin R, Puigserver MT, Delgado JM, et al. The assessment of neurological care needs in the health sector San Juan de Alicante by key informants model. Rev Neurol 1995; 23: 860–5

    PubMed  CAS  Google Scholar 

  27. Rasmussen BK, Olesen J. Symptomatic and non symptomatic headaches in a general population. Neurology 1992; 42: 1225–31

    Google Scholar 

  28. Gerth WC, Carides GW, Dasbach EJ, et al. The multinational impact of migraine symptoms on health care utilization and work loss. Pharmacoeconomics 2001; 19 (2): 197–206

    Google Scholar 

  29. Lipton RB, Scher AI, Kolodner K, et al. Migraine in the United States: epidemiology and patterns of health care use. Neurology 2002; 58: 885–94

    Google Scholar 

  30. Leira R, Lainez JM, Pascual J, et al. Spanish study of quality of life in migraine (I) profile of the patient with migraine attending neurology clinics. Neurologia 1998; 13: 287–91

    PubMed  CAS  Google Scholar 

  31. Cifras de poblaci´on. 1 julio 2000. INE, 2002. Available from URL: http://www.ine.es/inebase/cgi/um [online]. [Accessed 2002 May 15]

  32. Encuesta de poblaci´on activa. Total 2000. INE, 2002. Available Amerifrom URL: http://www.ine.es/inebase/cgi/um [online.] [Accessed 2002 May 15]

  33. Encuesta de salarios en la industria y los servicios. IV Trimestre 2000. INE, 2002. Available from URL: http://www.ine.es/inebase/cgi/um [online]. [Accessed 2002 May 15]

  34. Fishman P, Black L. Indirect costs of migraine in a managed care population. Cephalalgia 1999; 19: 50–7

    Google Scholar 

  35. Solomon GD, Price KL. Burden of migraine: a review of its socioeconomic impact. Pharmacoeconomics 1997; 11 Suppl. 1: 1–10

    Article  PubMed  Google Scholar 

  36. Canadian Coordinating Office for Health Technology Assessment. Guidelines for costing process. Ottawa (ON): CCOHTA, 1996

    Google Scholar 

  37. Gracia Naya M. Burden and management differences between migraine with and without aura in neurology clinics. Neurology 1999; 14: 383–8

    CAS  Google Scholar 

  38. Schwartz BS, Stewart WF, Lipton RB. Lost workdays and decreased work effectiveness associated with headache in the workplace. J Occup Environ Med 1997; 39: 320–7

    Article  PubMed  CAS  Google Scholar 

  39. Hu XH, Markson LE, Lipton RB, et al. Burden of migraine in the United States: disability and economic costs. Arch Intern Med 1999; 159: 813–8

    Article  PubMed  CAS  Google Scholar 

  40. Hodgson TA, Meiners MR. Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem Fund Q Health Soc 1982; 60: 429–62

  41. Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 14 (2): 171

    Article  PubMed  CAS  Google Scholar 

  42. Commonwealth of Australia. Guidelines for the pharmaceutical industry on preparation of submissions to the PharmaceuticalBenefits Advisory Committee: Including submissions involving economic analyses. Woden (ACT): Department of Health, EcoHousing and Community Services, 1990

  43. Muññiz R, Macia C, Montiel I, et al. Prevalence of migraine in calculatthe medical student population as determined by means of the ‘Alcoi 1992’ questionnaire. Rev Neurol 1995; 23: 866–9

    Google Scholar 

  44. Montiel I, Muñiz R, Asensio M, et al. Prevalencia de migrañña en una población homogénea utilizando el autocuestionario ‘Alcoi-1995’. Rev Neurol 1997; 25: 1177–80

    PubMed  CAS  Google Scholar 

  45. Von Korff M, Stewart WF, Simon DJ, et al. Migraine and reduced work performance: a population-based diary study. Neurology 1998; 50: 1741–5

    Article  Google Scholar 

  46. Stewart WF, Lipton RB, Simon D. Work-related disability: results from the American migraine study. Cephalalgia 1996; 16: 231–8

    Article  PubMed  CAS  Google Scholar 

  47. Edmeads J, Findlay H, Tugwell P, et al. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci 1993; 20: 131–7

    PubMed  CAS  Google Scholar 

  48. Menken M, Munsat TL, Toole JF. The global burden of disease study: implications for neurology. Arch Neurol 2000; 57: 418–20

    Article  PubMed  CAS  Google Scholar 

  49. López JJ, editor. Libro blanco. Estudio socioeconómico sobre el coste social de los trastornos de salud mental en Españña. Madrid: Gabinete de Estudios Sociológicos Bernard Krief, 1998

    Google Scholar 

  50. Jönsson B. The economic impact of diabetes. Diabetes Care 1998; 21 Suppl. 3: C7–10

    Google Scholar 

  51. Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001; 41: 646–57

    Article  PubMed  CAS  Google Scholar 

  52. Ferrari MD. The economic burden of migraine to society. Pharmacoeconomics 1998; 13 (6): 667–76

    Google Scholar 

  53. Lipton RB, Stewart WF, von Korff M. Burden of migraine: societal costs and therapeutic opportunities. Neurology 1997; 48 Suppl. 3: S4–9

    Article  Google Scholar 

  54. Clarke CE, McMillan L, Sondhi S, et al. Economic and social impact of migraine. Q J Med 1996; 89: 77–84

    Article  CAS  Google Scholar 

  55. Láinez JM. Prevalencia de la migranña en el medio laboral y su repercusión econ´omica. Rev Esp Med Trab 1995; 4 Suppl. 1: 3–9

    Google Scholar 

  56. Clouse JC, Osterhaus JT. Healthcare resource use and costs associated with a migraine in a managed care setting. Ann Pharmacother 1994; 28: 659–64

    PubMed  CAS  Google Scholar 

  57. de Lissovoy G, Lazarus SS. The economic cost of migraine: present state of knowledge. Neurology 1994; 44: 56–62

    Google Scholar 

  58. Stang P, Osterhaus JT. Impact of migraine in the United States: data from the National Health Interview Survey. Headache 1993; 33: 29–35

    Article  PubMed  CAS  Google Scholar 

  59. Osterhaus JT, Gutterman DL, Platchetka JR. Healthcare resource and lost labour costs of migraine headache in the US. Pharmacoeconomics 1992; 28: 659–64

    Google Scholar 

  60. Rasmussen BK, Jensen R, Olesen J. Impact of migraine on sickness, absence and utilisation of medical services: a Danish population study. J Epidemiol Community Health 1992; 46: 443–6

    Article  PubMed  CAS  Google Scholar 

  61. The Spanish economy: monthly report. Barcelona: “La Caixa”, 2002 (Dec)

  62. Bertola G, Blau FD, Kahn LM. Comparative analysis of labor market outcomes: lessons for the US from International LungRun Evidence. Cambridge, (MA): National Bureau of Economic Research, 2001: 9–10

    Google Scholar 

  63. Koopmanschap MA, Rutten FFH. A practical guide for calculating indirect costs of disease. Pharmacoeconomics 1996; 10 (5): 460–6

    Article  PubMed  CAS  Google Scholar 

  64. Drummond MF. Cost-of-illness studies: a major headache? [editorial]. Pharmacoeconomics 1992; 2 (1): 1–4

    Article  PubMed  CAS  Google Scholar 

  65. Brouwer WBF, Koopmanschap MA, Rutten FFH. Productivity losses without absence: measurement, validation and empirical evidence. Health Policy 1999; 48: 13–27

    Article  PubMed  CAS  Google Scholar 

  66. Andrasik F, Kabela E, Quinn S, et al. Psychological functioning of children who have recurrent migraine. Pain 1988; 34: 43–52

    Article  PubMed  CAS  Google Scholar 

  67. Lofland III, Locklear JC, Frick KD. Different approaches to valuing the lost productivity of patients with migraine. Pharmacoeconomics 2001; 19 (9): 917–

    Article  PubMed  CAS  Google Scholar 

  68. Dasbach EJ, Carides GW, Gerth WC, et al. Work and productivity loss in the rizatriptan multiple attack. Cephalalgia 2000; 20: 830–4

    Article  PubMed  CAS  Google Scholar 

  69. Wells NEJ, Steiner TJ. Effectiveness of eletriptan in reducing time loss caused by migraine attacks. Pharmacoeconomics 2000; 18 (6: 557–66

    Article  PubMed  CAS  Google Scholar 

  70. Auray JP, Chicoye A, Duru G, et al. Migraine et autres céphalées: étude descriptive et explicative de la consommation de soins. In: Henry P, Duru G, Chazot G, et al., editors. La migraine en France: etude épidémiologique, impact socio-économique et quality de vie. Paris: John Libbey Eurotext, 1993: 49–78

    Google Scholar 

  71. Celentano DD, Stewart WF, Lipton BB, et al. Medication use and disability among migraineurs: a national probability sample survey. Headache 1992; 32: 223–8

    Article  PubMed  CAS  Google Scholar 

  72. Micieli G. Suffering in silence. In: Edmeads J, editor. Migraine: a brighter future. Worthing: Cambridge Medical Publications, 1993: 1–7

    Google Scholar 

  73. Lipton RB, Stewart WF, Celentano DD, et al. Undiagnosed migraine headaches. Arch Intern Med 1992; 152: 1273–8

    Article  PubMed  CAS  Google Scholar 

  74. Steiner TJ. Long-term cost benefit assessment of anti-migraine drugs. Cephalalgia 1995; 15 Suppl. 15: 47–55

    Google Scholar 

  75. Dowson A, Jagger S. The UK migraine patient survey: quality of life and treatment. Curr Med Res Opin 1999; 15: 241–53

    Article  PubMed  CAS  Google Scholar 

  76. Lipton RB, Hamelski SW, Kolodner KB, et al. Migraine, quality of life and depression: a population-based case-control. Neurology 2000; 55: 629–35

    Article  PubMed  CAS  Google Scholar 

  77. Lainez JM. Migraña y calidad de vida. Neurologia 1998; 13 Suppl. 2: 1–8

    Google Scholar 

  78. Terwindt GM, Ferrari MD, Groenen SM, et al. The impact of migraine on quality of life in the general population: the GEM study. Neurology 2000; 55: 624–9

    Article  PubMed  CAS  Google Scholar 

  79. Osterhaus IT, Townsend RJ. The quality of life of migraineurs: a cross sectional profile. Cephalalgia 1991; 11 Suppl. 11: 103–4

    Google Scholar 

  80. Goadsby PJ, Lipton RB, Ferrari MD. Drug therapy: migraine: current understanding and treatment. N Engl J Med 2002; 346: 257–70

    Article  PubMed  CAS  Google Scholar 

  81. Ferrari MD, Roon KI, Lipton RB, et al. Triptans (serotonin, 5-HTIB/ID agonists) in acute migraine treatment: a meta-analysis of 53 trials. Lancet 2001; 358: 1668–75

    Article  PubMed  CAS  Google Scholar 

  82. Cady RC, Ryan R, Jhingran P, et al. Sumatriptan injections reduce productivity loss during a migraine attack: results of a double-blind, placebo-controlled trial. Arch Intern Med 1998; 158: 1013–8

    Article  PubMed  CAS  Google Scholar 

  83. Pascual J, Leira R, Lainez JM, et al. Estudio español de calidad de vida en migraña (II). Patron de consumo de fármacos y eficacia subjetiva. Neurologia 1999; 14 204–9

    PubMed  CAS  Google Scholar 

  84. Perry CM, Markham A. Sumatriptan: an updated review of its use in migraine. Drugs 1998; 55: 889–922

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Funding for this study was provided by Almirall Prodesfarma, S.A. The authors declare no other potential conflicts of interest.

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  1. Health Outcomes Research Europe, Barcelona, Spain

    Xavier Badia, Sol Magaz & Laura Gutiérrez

  2. Almirall Prodesfarma S.A., Barcelona, Spain

    Jordi Galván

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Badia, X., Magaz, S., Gutiérrez, L. et al. The Burden of Migraine in Spain. PharmacoEconomics 22, 591–603 (2004). https://doi.org/10.2165/00019053-200422090-00004

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