Revealing the true burden of migraine in the U.S.

Most people in the U.S. either know someone with migraine, or live with migraine themselves — and are all too familiar with the stigma associated with the disease. Often thought of as “just” experiencing a bad headache, the migraine community has been historically under-recognized and underserved — often cast off as “unable to cope” or, even worse, “drug seeking.”

In fact, migraine is a serious, chronic neurological disease that can profoundly impair a person’s ability to carry out everyday activities, maintain a work life, or attend family events. Patients endure and “manage” around this disruptive disease, and generally report poorer well-being compared to those without migraine.¹ Migraine can feel like a moderate-to-severe headache but complicated by nausea, vomiting, and at times a crippling sensitivity to light and sound.² Migraine patients can suffer from persistent post-migraine symptoms, can have trouble functioning normally^3,4, and have to rearrange their lives around the disease, often living in fear of the next event.

This disease takes a toll not only on an individual’s well-being, but also on the economy as a whole. Migraine carries heavy financial implications for the country’s healthcare system and economy: healthcare utilization and associated direct and indirect costs in the U.S. are estimated to total approximately $22 billion annually ($11 billion and $11 billion, respectively).⁵ People with migraine experience significantly higher annual healthcare costs than those without; costs for families of someone with migraine are approximately 70 percent higher than for families without.^5,6

Effective preventive therapy has the potential to reduce the billions spent each year on migraine. While approximately 3.5 million Americans currently take a preventive therapy for migraine,^7,8 as few as one in five migraine patients who begin a preventive therapy will continue use for a full year.^9,10 Moreover, fewer than five percent of patients with severe migraine receive appropriate care — encompassing initial consult and diagnosis to receiving appropriate preventive and acute medications.¹¹

Migraine patients may feel deprived of a normal life — they may feel that time has been taken from them, or live in fear of the next attack. More options for migraine management are needed.

This month, health professionals from approximately 100 countries are anticipated to convene for the 18th Congress of the International Headache Society in Vancouver, British Columbia, where new evidence will be presented about the biological mechanisms underlying migraine. These insights about the pathophysiology of migraine may help advance the science of migraine and its management.

At Amgen, our mission is to serve patients. With our collaborator Novartis, we are leading the fight against migraine and are committed to partnering with employers and payers to help make an impact on patients’ lives. We hope this will allow Amgen and Novartis to be an ally for the migraine community.

Learn more about recent findings in migraine pathophysiology at ScienceofMigraine.com.

Joshua Ofman, MD, MSHS, is Senior Vice President, Global Value, Access, & Policy at Amgen.

References

¹ Buse DC, Rupnow MF, Lipton RB. Assessing and managing all aspects of migraine: migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc. 2009;84(5):422-435.
² Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808.
³ D’Amico D, Tepper SJ. Prophylaxis of migraine: general principles and patient acceptance. Neuropsychiatr Dis Treat. 2008;4(6):1155-1167.
⁴ Cottrell CK, Drew JB, Waller SE, Holroyd KA, Brose JA, O’Donnell FJ. Perceptions and needs of patients with migraine: a focus group study. J Fam Pract. 2002;51(2):142-147.
⁵ Bonafede MM, Sapra S, Shah N, Tepper SJ, Cappell KA, Desai PR. Incremental Direct and Indirect Costs Associated With Migraine in the United States. 2016.
⁶ Stang PE, Crown WH, Bizier R, Chatterton ML, White R. The family impact and costs of migraine. Am J Manag Care. 2004;10(5):313-320.
⁷ Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343-349.
⁸ Marketscan data on file.  31March2017. Ref Type: Data File.
⁹ Hepp Z, Bloudek LM, Varon SF. Systematic review of migraine prophylaxis adherence and persistence. J Manag Care Pharm. 2014;20(1):22-33.
¹⁰ Hepp Z, Dodick DW, Varon SF, Gillard P, Hansen RN, Devine EB. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia. 2015;35(6):478-488.
¹¹ Dodick DW, Loder EW, Manack AA, et al. Assessing Barriers to Chronic Migraine Consultation, Diagnosis, and Treatment: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Headache. 2016.

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