The medical care utilization and costs associated with migraine headache.
OBJECTIVE
To describe the medical care use and costs associated with migraine.


METHODS
Retrospective 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.


METHODS
We 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.


METHODS
Survey 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.


RESULTS
Interview-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.


CONCLUSIONS
By 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.
Henry Ford Health System, Detroit, MI, USA. jlafata1@hfhs.org
Jennifer
J
Elston Lafata
Christina
C
Moon
Carol
C
Leotta
Ken
K
Kolodner
Laila
L
Poisson
Richard B
RB
Lipton
D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D008881:Migraine Disorders / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D012959:Socioeconomic Factors