Factors Associated with Direct Health Care Costs Among Patients with Migraine

Area of Science:

• Healthcare Economics
• Clinical Epidemiology
• Health Services Research

Background:

• Migraine significantly impacts patients and healthcare systems, with limited data on cost-associated factors.
• Prevalence: 18% of US women and 6% of US men experience migraine.
• This study addresses the heterogeneity in migraine patient costs.

Purpose of the Study:

• To identify characteristics associated with high healthcare expenditures in commercially insured migraine patients.
• To analyze demographic and clinical factors contributing to elevated migraine-related costs.

Main Methods:

• Retrospective analysis of MarketScan databases (2008-2013) for commercially insured migraine patients.
• Patients categorized into upper quartile (UQ) cohort based on >25th percentile of all-cause costs.
• Logistic regression and generalized linear models used to assess factors associated with UQ status and incremental costs.

Main Results:

• Over 850,000 patients analyzed; 83.2% female; average annual costs $13,045.
• ≥2 migraine-related ER visits doubled UQ likelihood (OR=2.13) and added $3,125 in costs.
• Neurologist visits increased UQ likelihood by 33%; opioid users showed 1.5-3x higher UQ likelihood and higher costs ($15,210 vs $8,888).

Conclusions:

• Modifiable factors like increased acute medication (opioids, triptans) and ER visits correlate with higher migraine costs.
• Findings support early intervention and targeted disease management for high-cost patients.
• Future research should explore disease severity's impact on healthcare utilization and costs.