• X H Hu, L E Markson, R B Lipton, W F Stewart, and M L Berger.
• Outcomes Research and Management, US Human Health Division, Merck Co Inc, West Point, PA, USA.
• Arch Intern Med. 1999 Apr 26;159(8):813-8.

BackgroundMigraine is a common disabling disease but its economic burden has not been adequately quantified.ObjectiveTo estimate the burden of migraine in the United States with respect to disability and economic costs.MethodsThe following data sources were used: published data, the Baltimore County Migraine Study, MEDSTAT's MarketScan medical claims data set, and statistics from the Census Bureau and the Bureau of Labor Statistics. Disability was expressed as bedridden days. Charges for migraine-related treatment were used as direct cost inputs. The human capital approach was used in the estimation of indirect costs.ResultsMigraineurs required 3.8 bed rest days for men and 5.6 days for women each year, resulting in a total of 112 million bedridden days. Migraine costs American employers about $13 billion a year because of missed workdays and impaired work function; close to $8 billion was directly due to missed workdays. Patients of both sexes aged 30 to 49 years incurred higher indirect costs compared with younger or older employed patients. Annual direct medical costs for migraine care were about $1 billion and about $100 was spent per diagnosed patient. Physician office visits accounted for about 60% of all costs; in contrast, emergency department visits contributed less than 1% of the direct costs.ConclusionsThe economic burden of migraine predominantly falls on patients and their employers in the form of bedridden days and lost productivity. Various screening and treatment regimens should be evaluated to identify opportunities to reduce the disease burden.

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