title: Burden of migraine in the United States: disability and economic costs.
abstract: BACKGROUND
  Migraine is a common disabling disease but its economic burden has not been adequately quantified.
  
  
  OBJECTIVE
  To estimate the burden of migraine in the United States with respect to disability and economic costs.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Migraineurs 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Outcomes Research and Management, US Human Health Division, Merck Co Inc, West Point, PA, USA.
authors.forename: X H
authors.initials: XH
authors.lastname: Hu
authors.forename: L E
authors.initials: LE
authors.lastname: Markson
authors.forename: R B
authors.initials: RB
authors.lastname: Lipton
authors.forename: W F
authors.initials: WF
authors.lastname: Stewart
authors.forename: M L
authors.initials: ML
authors.lastname: Berger
mesh_terms: D000041:Absenteeism; D000328:Adult; D017677:Age Distribution; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004526:Efficiency; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000191:economics* / Q000453:epidemiology*; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology