The burden of migraine in Spain -: Beyond direct costs

Objective: To estimate the economic burden of migraine in Spain, from the societal perspective. Methods: The Spanish 2001 annual direct (pharmacy, primary care, specialist and emergency room visits) and indirect (missed workdays and reduced work performance) costs were calculated using the prevalence approach. The human-capital method was used to calculate indirect costs. The sources used were published epidemiological and resource use studies using the International Headache Society diagnostic criteria from official and unofficial databases. Results: The Spanish population with migraine was estimated to be 3 617 600 patients, 92.5% being of a working age. The economic burden of migraine was about E1076 million. The direct costs represented only 32.0% of the total burden (E344 million), 39.2% being for primary care visits, 28.7% for specialist visits, 20.5% for emergency room visits and a further 11.7% for migraine-specific prescription drugs (serotonin 5-HT1B/1D receptor agonists [triptans] 10.8%, ergots 0.9%). The indirect cost was estimated at E732 million annually, representing E453.55 per working patient with migraine. Conclusions: As in many other developed countries, migraine represents a considerable economic burden in Spain, especially in terms of productivity losses. Therefore, activities should be specifically directed at reducing the indirect costs, and effective treatments, which significantly reduce productivity losses, should be publicly promoted.