The migraine ACE model: evaluating the impact on time lost and medical resource use

Objective.-To describe the Migraine Adaptive Cost-Effectiveness Model in th e context of an analysis of a simulated population of Canadian patients wit h migraine. Background.-The high prevalence of migraine and its substantial impact on p atients' ability to function normally present a significant economic burden to society. In light of the recent availability of improved pharmaceutical treatments, a model was developed to assess their economic impact. Methods.-The Migraine Adaptive Cost-Effectiveness Model incorporates the co sts of time lost From both work and nonwork activities, as well as medical resource and medication use. Using Monte Carlo techniques, the model simula tes the experience of a population of patients with migraine over the cours e of 1 year. As an example, analyses of a Canadian population were carried out using data from a multinational trial. surveys, national statistics, an d the available literature. Results.-Using customary therapy, mean productivity losses (amounting to 84 hours of paid work time, 48 hours of unpaid work time, and 113 hours of le isure time lost) were estimated to cost $1949 (in 1997 Canadian dollars) pe r patient, with medical expenditures adding an average of $280 to the cost of illness. Conclusions.-With customary treatment patterns, the costs of migraine assoc iated with reduced functional capacity are substantial. The migraine model represents a flexible tool for the economic evaluation of different migrain e treatments in various populations.