The total direct and indirect costs for treating patients with chronic migraines (CM) are 2.6 times higher than costs associated with episodic migraine (EM). Containing those costs through better management of the illness should be a priority, according to migraine researchers who led a nationwide study comparing the costs of CM and EM as part of the American Migraine Prevalence and Prevention (AMPP) Study.1
The term “CM,” often called “transformed migraine,” is based on growing evidence that migraine may be a chronic progressive disorder characterized by escalating frequency of headache attacks, or chronic migraine. More than 16,500 people with CM have enrolled in the AAMP study since 2004, and costs of headache-related health care visits were estimated using Current Procedural Terminology codes.
While about $6.62 is devoted each month for preventative medications for people with EM, and $32.97 monthly for acute pain management medications, patients with CM reported using $19.93 in preventative medications each month and $75.12 per month for acute medications. Triptans are the most expensive acute pharmacological therapy, representing $65.71 a month for patients with CM.
On an annual per-person cost basis, CM costs 3 times more for preventive medication ($239.16 vs $79.38) and more than twice as much for acute medication ($901.40 vs $395.62). The analysis also found that CM respondents made significantly more headache-related visits to physicians as outpatients (3.5 vs 1.1) and to emergency departments (0.5 vs 0.2), as well as to urgent care centers (0.1 vs 0.06). Annual per-person health care encounter cost was $656.42 for CM and $217.83 for EM, not including costs for diagnostic imaging or laboratory studies. The annual headache-related cost of medication and visits was $1796.98 for CM and $692.84 for EM.
CM respondents also made significantly more health care encounters for non-headache reasons, said Richard Lipton, MD, a neurologist and migraine specialist with the Albert Einstein College of Medicine in New York. EM participants in the study “reported significantly more primary care visits, neurologist or headache specialist visits, pain clinic visits, and emergency room visits compared with participants whose migraine remained episodic,” according to Lipton.
The AAMP is a 5-year longitudinal study of headache in the United States supported by the National Headache Foundation through grants from Ortho-McNeil Neurologics, Inc., and Allergan Inc.
1. Lipton RB, Manack AN, Chiao E, et al. Cost of healthcare utilization for chronic migraine and episodic migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study [P06.005]. Poster Session VI: Headache III. April 29, 2009.