OBJECTIVES: We aimed to estimate the annualized cost per patient with migraine, for the overall migraine population and according with the number of previous prophylactic treatment failures (TF) in Portugal based on the BECOME study.

METHODS: BECOME study is a non-interventional study conducted across 17 European countries and Israel between Nov2017-Aug2018 entailing Part-1 (cumulative hospital data) and Part-2 (patient-level data). Part 2 of the study included patients aged 18 to 65 years, attending headache centers as outpatients/inpatients, with a migraine diagnosis, >=4 monthly migraine days (MMD) and evidence of >=1 prophylactic TF in the previous 5 years. Annualized self-reported HCRU (emergency visits, hospitalizations, healthcare professional consultations) and corresponding costs for the NHS were calculated based on the unitary costs from available public data. Productivity losses were estimated based on the Work Productivity and Activity Impairment questionnaire (WPAI) migraine-specific version and considering the Human Capital Approach (using public sources for the labor unitary prices). All costs are expressed in 2019 euros.

RESULTS: The Portuguese sample of the BECOME study part 2 (n=103) had 99% females, mean age of 43.8 (SD=11.4), mean MMD of 10.4 (SD=6.1), 40%/29%/31% were TF1/TF2/TF3+, and 72.8% were currently employed. Migraine-related direct cost averaged €352/patient/year for the overall sample and €280/€400/€576 per TF1/TF2+/TF3+ patient. Indirect costs related with absenteeism and presenteeism due to migraine averaged €5,432/patient/year and €5,225/€5,568/€5,535 per TF1/TF2+/TF3+ patient. Total cost averaged 5,784 €/patient/year and €5,505/€5,969/€6,111 per TF1/TF2+/TF3+ patient.

CONCLUSIONS: Migraine-related costs are substantial, particularly those related with productivity loss, which is the major cost driver contributing with 94% to the overall cost. This study highlights the need for more effective treatments and better management of migraine in order to reduce the economic burden of this disease namely its impact on work.