In a collaborative study between Medaffcon, Novartis and Terveystalo the burden of disease of migraine was investigated. The study shows how real world data can be utilized for assessing the current status of migraine care and its impact on the healthcare system and society.
The highest prevalence of migraine is detected among people who are of working age and it reduces significantly both physical and social performance. In 2016 the global burden of disease study showed, that migraine was associated with the highest burden of years lived with disability worldwide in both men and women under the age of 50 years, highlighting the lack of effective disease management. Disease disability, health care resource use and direct costs increase simultaneously with increasing number of headache days. In our new study, the burden of migraine in Finnish health care was assessed by utilizing patient data collected in an occupational health care setting.
“Real world evidence provides data related to the real-life use and effects of health interventions. As healthcare resources are limited, they should be focused to places where interventions have the largest impact. For this purpose, identifying patients with a high disease burden can promote cost-effective treatments and improve decision making”, explains Mariann Lassenius, RWE Lead at Medaffcon and co-author of the study.
Electronic medical records (EMR) of a private health care provider Terveystalo were utilized in this retrospective register-based study. Patients who had given a written informed consent using occupational health care at Terveystalo (N = 369,383) were included. Altogether 17 623 migraine patients were identified, for which an age and gender matched control population was established. During the follow-up period of years 2012-2017 the number of occupational health care visits, sick–leave days and comorbidities were compared between these two groups.
The prevalence of migraine among occupational healthcare customers was 4.8-6.3 % and a majority of the patients (78.9 %) were women. Based on prescriptions 37 % of migraine patients received exclusively acute medication and 13 % prophylactic medication. Results showed that prophylactic treatment lines increased the healthcare resource use and sick–leave days, since the number of visits rose from 13.8 to 26.2 and sick-leave days from 16.8 to 30.4 in those without prophylaxis vs. ≥3 prophylactic treatment lines. Migraine patients had 1.7-fold increase in visits and 1.8-fold increase in sick–leave days on average per patient–year, compared to the control population. Depression and anxiety were 1.8-fold more common among patients with migraine and the frequency increased by prophylactic treatment line.
“This study provides new evidence on the burden of migraine. Study results indicate that migraine patients would benefit from more effective disease management and treatment, which would also provide tools to prevent detrimental effects on health and quality of life of patients “, concludes Lassenius.
Korolainen MA, Kurki S, Lassenius MI, Toppila I, Costa-Scharplatz M, Purmonen T, Nissilä M. Burden of migraine in Finland: health care resource use, sick-leaves and comorbidities in occupational health care. The Journal of Headache and Pain, 12;20(1):13, 2019. doi: 10.1186/s10194-019-0964-5.