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Addressing the cost of chronic and episodic migraine and its main drivers: a short-term longitudinal analysis from a third-level Italian center

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Abstract

Background

Chronic migraine (CM) is one of the most disabling neurological diseases, often associated to medication overuse headache (MOH). These patients make high use of pharmacological and non-pharmacological treatments, and experience high work-related indirect costs. The aim of this study was to address and compare the main driver of cost associated to CM-MOH and EM, and to evaluate the effect of improvement in migraine profile on disease cost.

Methods

We selected patients with baseline CM-MOH who reverted to an episodic pattern by 3 months after structured withdrawal. Paired sample t-test was used to explore the variation in headache frequency and its costs. Regression models were run to address the impact of single cost categories on total migraine cost.

Results

A total of 261 patients were included. Significant reductions in headache frequency and its costs were observed, with the exception of medical prophylaxis cost. The cost of migraine from chronic to episodic pattern is reduced by 533€ per month and 80% of this reduction is accountable to reduced indirect costs, i.e., loss of productive time.

Conclusions

The results of our study open to future considerations on future approaches to the treatment of CM-MOH in which new migraine-specific treatments, i.e., monoclonal antibodies, should be combined with other pharmacological and non-pharmacological ones.

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Funding

The MIND-CM project was funded by the Italian Ministry of Health under grant agreement number RF-2016–02364801. The MOH-Cost study was partially funded by FICEF Onlus.

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Authors and Affiliations

  1. UO Neurologia Salute Pubblica E Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Alberto Raggi, Erika Guastafierro, Alessia Marcassoli & Marco Passavanti

  2. UO Neuroalgologia – Centro Cefalee, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Licia Grazzi, Danilo Antonio Montisano & Domenico D’Amico

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  1. Alberto Raggi
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Correspondence to Alberto Raggi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Raggi, A., Grazzi, L., Guastafierro, E. et al. Addressing the cost of chronic and episodic migraine and its main drivers: a short-term longitudinal analysis from a third-level Italian center. Neurol Sci 43, 5717–5724 (2022). https://doi.org/10.1007/s10072-022-06164-y

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