• J Gen Intern Med · Oct 2004

    The medical care utilization and costs associated with migraine headache.

    • Elston LafataJenniferJHenry Ford Health System, Detroit, MI, USA. jlafata1@hfhs.org, Christina Moon, Carol Leotta, Ken Kolodner, Laila Poisson, and Richard B Lipton.
    • Henry Ford Health System, Detroit, MI, USA. jlafata1@hfhs.org
    • J Gen Intern Med. 2004 Oct 1; 19 (10): 100510121005-12.

    ObjectiveTo describe the medical care use and costs associated with migraine.DesignRetrospective case-control design in which migraine case status was ascertained via validated telephone interview and linked with comprehensive claims data. Unadjusted and adjusted use and cost differences by migraine status were evaluated using exponential score tests and generalized estimating equations.Setting And PatientsWe interviewed 8,579 individuals to identify migraine cases (N = 1,265) and a random sample of nonmigraine controls (N = 1,178) among eligible health plan enrollees aged 18 to 55.MeasuresSurvey responses were used to categorize individuals meeting the International Headache Society's diagnostic criteria for migraine with or without aura as migraine cases and to collect information on comorbid psychiatric symptoms. Claims data were used to compile annual medical and pharmaceutical use and costs, presence of migraine diagnosis, and other diagnosed comorbidities.ResultsInterview-ascertained migraine cases used more outpatient visits (9.1 vs 6.8; P < .01), were more likely to be seen in the emergency department (20.7% vs 17.6%; P < .05), and were admitted to the hospital more (4.5% vs 2.8%; P < .05) compared to nonmigraine controls. Cases incurred significantly higher medical care costs ($2,761 vs $2,064; P < .01). Multivariable model results indicate that much of this increase in costs is due to the presence of major depressive symptoms as well as other diagnosed comorbidities that are more common among those with migraine.ConclusionsBy combining validated telephone survey information to identify migraine cases and controls with comprehensive claims data, we found migraine cases incur higher medical care costs compared to controls. These increased costs are associated with the presence of psychiatric symptoms and other comorbidities.

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