Headache disorders incur ‘immense economic losses’ for the EU
MedWire News: The total annual societal cost of headache disorders to the EU, including direct and indirect factors, is around € 112 bn (US$ 148 bn), report researchers who found migraine to be the largest contributor at € 50 bn (US$ 66 bn).
"This has immediate implications for European healthcare policy because increased investments in effective healthcare not only have the potential to reduce these losses (whilst improving public health) but also are likely to be repaid several-fold by savings elsewhere," comment Mattias Linde (St Olavs University Hospital, Trondheim, Norway) and colleagues.
Published evidence indicates that migraine is the most costly neurologic disease for European society. However, there are large variations in the cost estimates across the few countries where data are available, owing to methodologic differences.
Indeed many studies use a "top-down" approach, which carries the risk for underestimating or omitting cost items that are not fully captured in national statistics.
"The general opinion is that available estimates of the cost of migraine in Europe are underestimations," Linde et al comment in the European Journal of Neurology.
What is more, the economic impact of other headache disorders such as tension-type headache (TTH) and medication-overuse headache (MOH) is virtually unknown.
The researchers therefore performed a cross-sectional survey conducted in eight EU countries including a total of 8412 completed questionnaires.
Using bottom-up methodology, they estimated direct (medications, outpatient health care, hospitalization, and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, derived from a systematic review, were used to determine national costs.
Mean per-person annual costs were € 1222 (US$ 1618) for migraine (indirect costs 93%), € 303 (US$ 401) for TTH (indirect costs 92%), € 3561 (US$ 4713) for MOH (indirect costs 92%), and € 253 (US$ 335) for other headaches (indirect costs 82%).
"We found that, contrary to other neurological diseases, indirect costs dominated," Linde et al comment.
In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to the team's prevalence estimates, at € 173 bn (US$ 229 bn), apportioned to migraine (€ 111 bn, US$ 147 bn; 64%), TTH (€ 21 bn, US$ 28 bn; 12%), MOH (€ 37 bn, US$ 49 bn; 21%), and other headaches (€ 3 bn, US$ 4 bn; 2%).
Linde et al then conducted a sensitivity analysis using the prevalence of migraine in Europe established by a systematic review. Recalculating on this basis reduced the cost of migraine to € 50 bn (US$ 66 bn) annually and of all headache to € 112 bn (US$ 148 bn) annually.
"This report underlines the prominent position of headache disorders, migraine especially but far from exclusively, amongst all health disorders as drivers of immense economic losses to society," Linde et al comment.
By Andrew Czyzewski