OBJECTIVES:

Migraine is estimated to affect 7.6% of men and 18.3% of women in England. We evaluated health care resource use (HCRU) and costs in primary and secondary care among patients with an incident diagnosis of migraine.

METHODS:

An observational study of migraine patients ≥18 years of age with primary care data linked to Hospital Episode Statistics data during 01/01/2015 - 31/12/2015. Annual HCRU and associated costs (reported in 2015 GBP (£)) were assessed 12-months post-index diagnosis. Direct HCRU included primary care visits, referrals to secondary care, inpatient, outpatient and emergency visits and migraine prescribing in primary care. Migraine prescribing was categorised as none, acute only, prophylactic only, acute and prophylactic. HCRU was estimated as consultation rates/person-year and 95% confidence intervals and mean costs were calculated. Cost data was obtained from National Health Service tariff data.

RESULTS:

2,859 patients were included (mean age 40, females 76.6%). Patients made an average of 13.21 primary care visits, 2.16 outpatient attendances and were hospitalized 0.33 times for any cause. HCRU tended to be higher among females, patients ≥40 years old and those prescribed prophylactic treatment (about 11 prescriptions/year). Average migraine related visits in primary and secondary care was about 1.5 visits/person.

Direct annual expenditure was approximately £4.21M of which £650K comprised of GP and nursing costs and £1.18M was due to hospitalizations (over 15% of hospitalisation costs was due to migraine). Migraine prescribing accounted for about £1.35M with the mean annual cost of prophylactic therapy being about £970 per person in contrast to £36.27/person for acute treatment (mean of 3.67 prescriptions/year).

CONCLUSIONS:

Female patients with incident migraine, older age groups, and patients prescribed prophylactic treatment had higher HCRU and economic burden 12 months following diagnosis. Further research is needed to optimise treatment for newly diagnosed migraine patients to improve clinical and economic outcomes.