OBJECTIVES : To revise the number, trends and characteristics of the Spanish population affected by headaches and migraine, together with the direct medical cost that these patients represent for the healthcare system.

METHODS : A retrospective multicentre study was designed including records from all patients admitted with headache in primary and secondary care centres in Spain between 2011 and 2016 registered in a Spanish claims database. ICD9 and ICD10 and the International Classification of Primary Care codes were used for data claiming. The standardised average expenses of medical procedures determined by the Spanish Ministry of Health were utilised for the calculation of direct medical costs.

RESULTS : Data extraction claimed primary care records from 636,722 patients and secondary care records from 30,077 patients. Females represented 60% and 65% of all patients with headache in primary and secondary care respectively, with the exception of cluster headaches, a group with 60% male patients. No large shifts were observed over time in patients’ profile; contrarily, overall number of admissions increased 5 folds during the study period. On average, 3 admissions were registered per patient in primary care, one in secondary care, and most of them were classified as urgent. Migraine was the cause for 32% of primary care consultations and 50% of secondary care admissions, and this disorder was responsible for the largest portion of healthcare costs in 2016, a total amount of € 7,302,718. The estimated annual direct medical cost of headaches was € 10,716,086.

CONCLUSIONS : Migraine was responsible for half of secondary care admissions linked to headache disorders. The total number of admissions increased 5 folds over the study period, a raise likely to impact the direct medical costs associated to these disorders causing an increase in the total burden for the Spanish society.