title: The burden of migraine in Spain: beyond direct costs.
abstract: OBJECTIVE
  To estimate the economic burden of migraine in Spain, from the societal perspective.
  
  
  METHODS
  The Spanish 2001 annual direct (pharmacy, primary care, specialist and emergency room visits) and indirect (missed workdays and reduced work performance) costs were calculated using the prevalence approach. The human-capital method was used to calculate indirect costs. The sources used were published epidemiological and resource use studies using the International Headache Society diagnostic criteria from official and unofficial databases.
  
  
  RESULTS
  The Spanish population with migraine was estimated to be 3,617,600 patients, 92.5% being of a working age. The economic burden of migraine was about euro 1076 million. The direct costs represented only 32.0% of the total burden (euro 344 million), 39.2% being for primary care visits, 28.7% for specialist visits, 20.5% for emergency room visits and a further 11.7% for migraine-specific prescription drugs (serotonin 5-HT(1B/1D) receptor agonists [triptans] 10.8%, ergots 0.9%). The indirect cost was estimated at euro 732 million annually, representing euro 453.55 per working patient with migraine.
  
  
  CONCLUSIONS
  As in many other developed countries, migraine represents a considerable economic burden in Spain, especially in terms of productivity losses. Therefore, activities should be specifically directed at reducing the indirect costs, and effective treatments, which significantly reduce productivity losses, should be publicly promoted.
authors.affiliation: Health Outcomes Research Europe, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Badia
authors.forename: Sol
authors.initials: S
authors.lastname: Magaz
authors.forename: Laura
authors.initials: L
authors.lastname: Gutiérrez
authors.forename: Jordi
authors.initials: J
authors.lastname: Galván
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004876:Ergot Alkaloids / Q000191:economics / Q000627:therapeutic use; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D018803:Models, Economic; D011320:Primary Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D017366:Serotonin Receptor Agonists / Q000191:economics / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology
chemical_list: D004876:Ergot Alkaloids; D017366:Serotonin Receptor Agonists