Migraine Economics

Migraine Management Toolkit

Migraine affects one in eight American adults. Prevalence peaks during prime productive years, between the ages of 25 and 55, at a time when work and family responsibilities are most significant. Although the prevalence of migraine far surpasses that of diabetes, it rarely makes the list of chronic conditions that get an employer’s attention. This is partly because migraines, on the surface, appear inexpensive to treat.

However, as the condition is looked at more closely, the true cost of migraine comes to light. In 2016, annual direct and indirect costs related to migraines were an estimated $36 billion. This figure doesn’t take into account the many individuals with migraines who go undiagnosed and others who seek care but are misdiagnosed, not an uncommon occurrence.

Direct Costs

Because migraines are a complex condition, migraineurs are more likely to use health care services including doctor visits and medications. This has caused an increase in related direct health care costs faced by employers. A recent study published in AJMC found that costs for patients with migraines were $6,575 higher than for those who do not have migraines. Of this:

  • 47% was for outpatient services
  • 26% was for outpatient medications
  • 20% was for inpatient services
  • 7% was for emergency room services

Put in another way, migraineurs had a significantly greater number of visits to the doctor’s office and pharmacy claims, they were three times more likely to have an inpatient admission and were more than twice as likely to use the ER.

Indirect Costs

Ninety-percent of migraine sufferers cannot work or function normally during their migraine. This has a negative impact on presenteeism (e.g. performance while on the job), and productivity including absenteeism, short-term disability and long-term disability.

According to a recent study released by the Integrated Benefits Institute (IBI):

  • When an employee takes short-term disability leave for migraines, they average 38 work days missed per episode, at an estimated cost of $10,400
  • If they continue on to long-term disability, additional costs are about $37,000 per year
  • Thirty-seven percent of long-term disability claims remained active after two years
  • Employees treated for migraines had an average of 2.2 more sick days per year than other employees

The good news is that incurring these higher indirect costs does not have to be the norm. When migraines are identified and properly treated, employees can stay at work and be productive.

Keep in mind that all of these statistics involve people who have been diagnosed with migraines. The cost becomes a much greater issue when you consider that half of those suffering from migraines fall through the cracks and are never diagnosed.