title: National Trends in Direct Health Care Expenditures Among US Adults With Migraine: 2004 to 2013.
abstract: Migraine is a common neurological disorder with significant economic burden in the United States. However, changes in the economic burden of migraine in the past decade have not been examined considering therapeutic advances at the national level. Therefore, we estimated cross-sectional trends in the incremental total and types of direct health care expenditures among individuals with migraine using nationally representative data, the Medical Expenditures Panel Survey. The analytic sample was comprised of an annually weighted population of 228,010,000 adults aged 18 years and older from 2004 to 2013. Two-part models were used to estimate the incremental total and types of annual direct health care expenditures (adjusted to 2013 US dollars) among individuals with migraine after adjusting for predisposing, enabling, need, personal health practice, and external environment factors selected on the basis of the Anderson Healthcare Behavior Model. The unadjusted average annual total health care expenditure for individuals with migraine was $8,033 (standard error [SE] = $292) which comprised major proportions of outpatient ($2,952, SE = $128), prescription drugs ($2,207, SE = $91), and inpatient ($1,784, SE = $178) expenditures. Individuals with migraine had $866 (SE = $298) and $1,519 (SE = $400) greater adjusted annual total direct health care expenditures in 2004/2005 and 2012/2013 compared with those without migraine. However, those with migraine in 2012/2013 did not have significant changes in the total direct health care expenditures compared with those having migraine in 2004/2005 (changes: -$330, SE = $480). The estimated adjusted incremental total direct health care expenditures for individuals with migraine was approximately $9.20 billion per year compared with those without migraine.
  
  
  
  Although annual incremental total direct health care expenditures among individuals with migraine did not change significantly from 2004 to 2013, expenditures remained significantly greater in the migraine population compared with those without migraine across the years. Our study findings suggest the need to design and implement policy and interventions to reduce excess health care expenditures among individuals with migraine.
authors: Healthcore, Inc, Wilmington, Delaware.
authors: Amit D
authors: AD
authors: Raval
authors: Department of Pharmacotherapy and Outcomes Sciences, Virginia Commonwealth University, Richmond, Virginia. Electronic address: shaha5@vcu.edu.
authors: Anal
authors: A
authors: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: 2-part model; Migraine; direct health care expenditures; economic burden; trends