OBJECTIVES: Migraine is an idiopathic chronic disease characterized by episodes of moderate to severe headache. Migraine is a common cause of disability and loss of work capacity. The analysis aimed to estimate the social costs and health losses associated with Migraine patients in Bulgaria. Currently, ICD code of Migraine is not included in the List of diseases paid by the NHIF in Bulgaria.

METHODS: The costs of illness were estimated using a prevalence-based approach. The analysis aims to cover all costs related to the control of Migraine from the perspective of the payer (NHIF) and society. The analysis examines direct medical costs primarily associated with pharmacotherapy and medical care to manage the disease and indirect costs associated with lost productivity. The time horizon of the analysis is one year. The main sources of information were hospitals database; expert opinions of KoLs in Bulgaria; medicine consumption and price data.

RESULTS: The results show that the direct costs per patient amount to BGN 848.29 per year, and the indirect costs amount to BGN 1 386.50 per year. The result of the economic evaluation shows that the direct medical costs for the migraine-affected population amount to BGN 165,620,297.38, of which BGN 138,999,298.02 are for pharmacotherapy paid by the patients. The cost of medical activities amounted to BGN 26 620 999,36. Indirect costs are estimated at BGN 270 700 517,89 (BGN 151 283 810,52 as a result of absenteeism and BGN 119 416 707,37 as a result of presenteeism (60% impaired performance).

CONCLUSIONS: The current analysis recommends the inclusion of the disease with the relevant code of the ICD-10 in the list of diagnoses for which the NHIF pays for treatment. The inclusion of Migraine in local pharmacotherapeutic guidelines will enable physicians to conduct treatment consistent with international clinical practice.