HEALTH-CARE RESOURCE USE AND COSTS ASSOCIATED WITH MIGRAINE IN A MANAGED HEALTH-CARE SETTING

OBJECTIVE: To compare healthcare use and associated costs in patients with migraine and patients without migraine headache. DESIGN: Retrospe ctive review of a managed care organization's medical and pharmacy cla ims databases for claims filed between January 1, 1989 and June 30, 19 90. PATIENTS: Patients between 18 and 64 years old with a 12-month min imum enrollment in the health plan, including enrollment for the presc ription drug benefit. Migraine group (n=1336) inclusion required a med ical claim with the diagnosis of migraine headache and a pharmacy clai m for a medication potentially used for migraine treatment. Comparison group (n=1336) inclusion required at least one medical claim with no diagnosis of migraine; a pharmacy claim was not required. Comparison g roup patients were matched to migraine group patients by age, gender, enrollment status, and subscriber or dependent enrollment status. OUTC OME MEASURES: Total health services use, diagnosis-specific use of ser vices, diagnostic procedures performed, comorbid conditions, medicatio n use, and associated costs were tallied. RESULTS: Migraineurs generat ed nearly twice as many medical claims as comparison group patients, a nd nearly 2.5 times as many pharmacy claims. Number of claims generate d and numbers of patients who generated claims within each of 19 diagn ostic categories indicated greater comorbidity in the migraine group. Migraineurs used emergency services more than did patients in the comp arison group. Total medical and pharmacy claims costs were $3.4 millio n for the migraine group and $2.1 million for the comparison group. Th e average amount paid per member-month of enrollment was significantly greater in the migraine group than in the comparison group. Comorbid conditions were responsible for a significant portion of costs in the migraine group. The migraine group incurred $83 537 for diagnostic pro cedures compared with $13 140 incurred by the comparison group. CONCLU SIONS: Patients with migraine had greater morbidity in general and inc urred 64 percent greater costs in healthcare resource use compared wit h patients without migraine.