OBJECTIVES: Migraine is a chronic sometimes highly disabling neurological disease that manifests itself with recurrent episodes of headache. It is expected that migraine is associated with a hugely healthcare and non-healthcare resources consumption. This study estimated the cost-of-illness (COI) of migraine from the perspective of Society in Spain, and characterized the excess cost of migraineurs versus non-migraineurs.

METHODS: The nationwide representative cross-sectional year-2020 European-Health-Survey-in-Spain was used to abstract data of persons 15+ years; 1,442 migraineurs (77.3% women, 52.5 years) and 4,288 non-migraineurs (76.7% women, 52.8 years) obtained by propensity score optimal matching. COI accounted healthcare resources utilization (HRU) funded by both the National Health System (NHS) and the participant, and non-HRU (absenteeism, presenteeism, unemployment, premature retirement). Human capital method was applied to estimate indirect costs, while healthcare costs were computed by multiplying HRU frequency by its unitary price. Costs were expressed as Per-Patient-Per-Year (PPPY) in Euros year 2020. Univariate general linear models with robust standard error estimation for differences were applied.

RESULTS: The PPPY cost was slightly more than double in migraineurs; €5,911 vs €2,966; excess cost of €2,945€ (95% CI: 2,551-3,339, p<0.001), mainly attributable to losses in labor productivity; €1,918 (1,574-2,261) annually (65.1% of total excess cost), being absenteeism the main driver; €630€ (21.4%) and 23.3 (19.0-27.5) extra sick-leave days in migraineurs, p<0.001. NHS-funded healthcare PPPY cost represented the 30.5% of total excess cost; €898 (736-1,061), mainly due to higher utilization of medical visits.

CONCLUSIONS: In Spain, from a nationwide society perspective, migraineurs showed a meaningful per-patient-per-year excess cost compared with non-migraineurs. Given that it is expected to have about 3.5 million migraineurs in Spain, the overall economic impact was estimated to be above 10,502 million Euros in year 2020. As in many other developed countries, most of the excess cost was driven by productivity losses.