Abstract
A recent health economic survey in Europe has suggested that migraine is the costliest among the neurological disorders. According to many studies, migraine and other disorders lead to widespread suffering, reduction of quality of life, and marked impairment of participation, both in work and social activities. The present literature survey was made in order to summarize what is known on the subject, as a preparation for a EU-supported study to assess the impact in several EU countries with similar methodology and the same research instrument. Previous studies have yielded relatively reliable data only for migraine, whereas the impact of tension-type headache is virtually unknown or only very incompletely known for most dimensions of headache impact. Some data do suggest, however, that this headache may be as important from a health economic and a public health perspective as migraine. In future studies it is important to get population-based data from various countries relevant for estimation of indirect (mostly absenteeism from work and reduced working efficiency when having headache) and direct costs (related to medication, consultations, investigations and hospitalisations). Also, the impact on ability to get education and participate in the workforce is very relevant, as is the impact on love life and family planning. The quality of life of headache patients should be measured by validated instruments. To get a complete picture, one should also ask about the effect on the life of partners and children, and on the possible impact even when headache-free (e.g. fear of the next attack).
Keywords: Burden, Disability, Eurolight, Headache, Impact, Migraine
Full Text
The Full Text of this article is available as a PDF (210.8 KB).
Acknowledgments
Conflict of interest
The first author has received honoraria, travel grants or research grants from GSK, Pfizer, Almirall, Nycomed, Desitin Pharma, MSD, Serono, AstraZeneca.
References
- 1.Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210. doi: 10.1111/j.1468-2982.2007.01288.x. [DOI] [PubMed] [Google Scholar]
- 2.Steiner TJ. Lifting the burden: the global campaign against headache. Lancet Neurol. 2004;3:204–205. doi: 10.1016/S1474-4422(04)00703-3. [DOI] [PubMed] [Google Scholar]
- 3.Andlin-Sobocki P, Jönsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12:1–27. doi: 10.1111/j.1468-1331.2005.01202.x. [DOI] [PubMed] [Google Scholar]
- 4.Hagen K, Vatten L, Stovner LJ, Zwart JA, Krokstad S, Bovim G. Low socio-economic status is associated with increased risk of frequent headache: a prospective study of 22718 adults in Norway. Cephalalgia. 2002;22:672–679. doi: 10.1046/j.1468-2982.2002.00413.x. [DOI] [PubMed] [Google Scholar]
- 5.Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA. 1992;267:64–69. doi: 10.1001/jama.267.1.64. [DOI] [PubMed] [Google Scholar]
- 6.Breslau N, Davis GC, Andreski P. Migraine, psychiatric disorders, and suicide attempts: an epidemiologic study of young adults. Psychiatry Res. 1991;37:11–23. doi: 10.1016/0165-1781(91)90102-U. [DOI] [PubMed] [Google Scholar]
- 7.Rasmussen BK. Migraine and tension-type headache in a general population: psychosocial factors. Int J Epidemiol. 1992;12:1138–1143. doi: 10.1093/ije/21.6.1138. [DOI] [PubMed] [Google Scholar]
- 8.Steiner TJ, Scher AI, Stewart WF, Kolodner K, Liberman J, Lipton RB. The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity. Cephalalgia. 2003;23:519–527. doi: 10.1046/j.1468-2982.2003.00568.x. [DOI] [PubMed] [Google Scholar]
- 9.Linde M, Dahlöf C. Attitudes and burden of disease among self-considered migraineurs—a nation-wide population-based survey in Sweden. Cephalalgia. 2004;24:455–465. doi: 10.1111/j.1468-2982.2004.00703.x. [DOI] [PubMed] [Google Scholar]
- 10.Gobel H, Petersen-Braun M, Soyka D. The epidemiology of headache in Germany: a nationwide survey of a representative sample on the basis of the headache classification of the International Headache Society. Cephalalgia. 1994;14:97–106. doi: 10.1046/j.1468-2982.1994.1402097.x. [DOI] [PubMed] [Google Scholar]
- 11.Launer LJ, Terwindt GM, Ferrari MD. The prevalence and characteristics of migraine in a population-based cohort: the GEM study. Neurology. 1999;53:537–542. doi: 10.1212/wnl.53.3.537. [DOI] [PubMed] [Google Scholar]
- 12.Stang P, Korff M, Galer BS. Reduced labor force participation among primary care patients with headache. J Gen Intern Med. 1998;13:296–302. doi: 10.1046/j.1525-1497.1998.00094.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Boardman HF, Thomas E, Croft PR, Millson DS. Epidemiology of headache in an English district. Cephalalgia. 2003;23:129–137. doi: 10.1046/j.1468-2982.2003.00468.x. [DOI] [PubMed] [Google Scholar]
- 14.Nikiforow R, Hokkanen E. Effects of headache on working ability: a survey of an urban and a rural population in Northern Finland. Headache. 1979;19:214–218. doi: 10.1111/j.1526-4610.1979.hed1904214.x. [DOI] [PubMed] [Google Scholar]
- 15.Benassi G, D’Alessandro R, Lenzi PL, Manzaroli D, Baldrati A, Lugaresi E. The economic burden of headache: an epidemiological study in the Republic of San Marino. Headache. 1986;26:457–459. doi: 10.1111/j.1526-4610.1986.hed2609457.x. [DOI] [PubMed] [Google Scholar]
- 16.Rasmussen BK, Jensen R, Olesen J. Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Commun Health. 1992;42:443–446. doi: 10.1136/jech.46.4.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Stovner LJ, Zwart JA, Hagen K, Terwindt G, Pascual J. Epidemiology of headache in Europe. Eur J Neurol. 2006;13:333–345. doi: 10.1111/j.1468-1331.2006.01184.x. [DOI] [PubMed] [Google Scholar]
- 18.Fiane I, Haugland M, Stovner L, Zwart JA, Bovim G, Hagen K. Sick leave is related to frequencies of migraine and non-migrainous headache—the HUNT Study. Cephalalgia. 2006;26:960–967. doi: 10.1111/j.1468-2982.2006.01151.x. [DOI] [PubMed] [Google Scholar]
- 19.Michel P, Dartigues JF, Duru G, Moreau J, Salamon R, Henry P. Incremental absenteeism due to headaches in migraine: results from the Mig-Access French national cohort. Cephalalgia. 1999;19:503–510. doi: 10.1046/j.1468-2982.1999.019005503.x. [DOI] [PubMed] [Google Scholar]
- 20.Berg J. Economic evidence in migraine and other headaches: a review. Eur J Health Econom. 2004;5:S43–S54. doi: 10.1007/s10198-005-0288-z. [DOI] [PubMed] [Google Scholar]
- 21.Pransky GS, Berndt E, Finkelstein SN, Verma S, Agrawal A. Performance decrements resulting from illness in the workplace: the effect of headaches. J Occup Environ Med. 2005;47:34–40. doi: 10.1097/01.jom.0000150208.20117.34. [DOI] [PubMed] [Google Scholar]
- 22.Michel P, Auray J, Chicoye A, Dartigues J, Lamure D, Duru G, Henry P, Salamon R. Prise en charge des migraineux en France: Coût et recours aux soins. J Econ Med. 1993;11:71–80. [Google Scholar]
- 23.Auray JP. Impact socio-economique de la migraine et des cephalees en France. CNS Drugs. 2006;20(Spec no.1):37–46. [PubMed] [Google Scholar]
- 24.Neubauer G, Uljaky R. Migraine-a disease and its costs. Pharm Unserer Zeit. 2002;31:494–497. doi: 10.1002/1615-1003(200209)31:5<494::AID-PAUZ494>3.0.CO;2-G. [DOI] [PubMed] [Google Scholar]
- 25.Roijen L, Essink-Bot ML, Koopmanschap MA, Michel BC, Rutten FF. Societal perspective on the burden of migraine in The Netherlands. Pharmacoeconomics. 1995;7:170–179. doi: 10.2165/00019053-199507020-00008. [DOI] [PubMed] [Google Scholar]
- 26.Lainez MJA, Monzon MJ (2003) The socioeconomic impact of migraine in Spain. In: Reducing the burden of headache. Oxford University Press, Oxford, pp 255–259
- 27.Björk S, Roos P (1991) Economic aspects of migraine in Sweden. In: Working paper no 8 Institute for Health Economics, Lund. pp 5–24
- 28.Blau N, Drummond M. Migraine. London: Office of Health Economics; 1991. pp. 26–30. [Google Scholar]
- 29.Cull R, Wells N. The economic cost of migraine. Br J Med Econ. 1992;2:103–115. [Google Scholar]
- 30.Berg J, Stovner LJ. Cost of migraine and other headaches in Europe. Eur J Neurol. 2005;12(Suppl 1):59–62. doi: 10.1111/j.1468-1331.2005.01192.x. [DOI] [PubMed] [Google Scholar]
- 31.Rasmussen BK, Jensen R, Olesen J. Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Commun Health. 1992;46:443–446. doi: 10.1136/jech.46.4.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Boardman HF, Thomas E, Croft PR, Millson DS. Epidemiology of headache in an English district. Cephalalgia. 2003;23:129–137. doi: 10.1046/j.1468-2982.2003.00468.x. [DOI] [PubMed] [Google Scholar]
- 33.Badia X, Magaz S, Gutierrez L, Galvan J. The burden of migraine in Spain: beyond direct costs. Pharmacoeconomics. 2004;22:591–603. doi: 10.2165/00019053-200422090-00004. [DOI] [PubMed] [Google Scholar]
- 34.Pradalier A, Auray JP, El Hasnaoui A, Alzahouri K, Dartigues JF, Duru G, Henry P, Lanteri-Minet M, Lucas C, Chazot G, et al. Economic impact of migraine and other episodic headaches in France: data from the GRIM2000 study. Pharmacoeconomics. 2004;22:985–999. doi: 10.2165/00019053-200422150-00003. [DOI] [PubMed] [Google Scholar]
- 35.Elston Lafata J, Moon C, Leotta C, Kolodner K, Poisson L, Lipton RB. The medical care utilization and costs associated with migraine headache. J Gen Intern Med. 2004;19:1005–1012. doi: 10.1111/j.1525-1497.2004.30021.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Lucas C, Chaffaut C, Artaz MA, Lantéri-Minet M. FRAMIG 2000: medical and therapeutic management of migraine in France. Cephalalgia. 2005;25:267–279. doi: 10.1111/j.1468-2982.2004.00851.x. [DOI] [PubMed] [Google Scholar]
- 37.Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R. Secular changes in health care utilization and work absence for migraine and tension-type headache: a population based study. Eur J Epidemiol. 2005;20:1007–1014. doi: 10.1007/s10654-005-3778-5. [DOI] [PubMed] [Google Scholar]
- 38.Dueland AN, Leira R, Burke TA, Hillyer EV, Bolge S. The impact of migraine on work, family, and leisure among young women—a multinational study. Curr Med Res Opin. 2004;20:1595–1604. doi: 10.1185/030079904X3357. [DOI] [PubMed] [Google Scholar]
- 39.Hu XH, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med. 1999;159:813–818. doi: 10.1001/archinte.159.8.813. [DOI] [PubMed] [Google Scholar]
- 40.Dahlöf CG, Dimenäs E. Migraine patients experience poorer subjective well-being/quality of life even between attacks. Cephalalgia. 1995;15:31–36. doi: 10.1046/j.1468-2982.1995.1501031.x. [DOI] [PubMed] [Google Scholar]
- 41.Hamelsky SW, Lipton RB, Stewart WF. An assessment of the burden of migraine using the willingness to pay model. Cephalalgia. 2005;25:87–100. doi: 10.1111/j.1468-2982.2005.00797.x. [DOI] [PubMed] [Google Scholar]
- 42.Morillo LE, Alarcon F, Aranaga N, Aulet S, Chapman E, Conterno L, Estevez E, Garcia-Pedroza F, Garrido J, Macias-Islas M, et al. Prevalence of migraine in Latin America. Headache. 2005;45:106–117. doi: 10.1111/j.1526-4610.2005.05024.x. [DOI] [PubMed] [Google Scholar]
- 43.Steiner TJ. Lifting the burden: the global campaign to reduce the burden of headache worldwide. J Headache Pain. 2005;6:373–377. doi: 10.1007/s10194-005-0241-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 44.Leonardi M, Steiner TJ, Scher AT, Lipton RB. The global burden of migraine: measuring disability in headache disorders with WHO’s Classification of Functioning, Disability and Health (ICF) J Headache Pain. 2005;6:429–440. doi: 10.1007/s10194-005-0252-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 45.Olesen J, Leonardi M. The burden of brain diseases in Europe. Eur J Neurol. 2003;10:471–477. doi: 10.1046/j.1468-1331.2003.00682.x. [DOI] [PubMed] [Google Scholar]
- 46.Osterhaus JT, Townsend RJ, Gandek B, Ware JE. Measuring the functional status and well-being of patients with migraine headache. Headache. 1994;34:337–343. doi: 10.1111/j.1526-4610.1994.hed3406337.x. [DOI] [PubMed] [Google Scholar]
- 47.Terwindt GM, Ferrari MD, Tijhuis M, Groenen SM, Picavet HS, Launer LJ. The impact of migraine on quality of life in the general population: the GEM study. Neurology. 2000;55:624–629. doi: 10.1212/wnl.55.5.624. [DOI] [PubMed] [Google Scholar]
- 48.Guitera V, Muñoz P, Castillo J, Pascual J. Quality of life in chronic daily headache: a study in a general population. Neurology. 2002;58:1062–1065. doi: 10.1212/wnl.58.7.1062. [DOI] [PubMed] [Google Scholar]
- 49.Colás R, Muñoz P, Temprano R, Gómez C, Pascual J. Chronic daily headache with analgesic overuse: epidemiology and impact on quality of life. Neurology. 2004;62:1338–1342. doi: 10.1212/01.wnl.0000120545.45443.93. [DOI] [PubMed] [Google Scholar]
- 50.Lipton RB, Liberman JN, Kolodner KB, Bigal ME, Dowson A, Stewart WF. Migraine headache disability and health-related quality-of-life: a population-based case–control study from England. Cephalalgia. 2003;23:441–450. doi: 10.1046/j.1468-2982.2003.00546.x. [DOI] [PubMed] [Google Scholar]
- 51.Bingefors K, Isacson D. Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain–a gender perspective. Eur J Pain. 2004;8:435–450. doi: 10.1016/j.ejpain.2004.01.005. [DOI] [PubMed] [Google Scholar]
- 52.Michel P, Dartigues JF, Lindoulsi A, Henry P. Loss of productivity and quality of life in migraine sufferers among French workers: results from the GAZEL cohort. Headache. 1997;37:71–78. doi: 10.1046/j.1526-4610.1997.3702071.x. [DOI] [PubMed] [Google Scholar]
- 53.Lipton RB, Hamelsky SW, Kolodner KB, Steiner TJ, Stewart WF. Migraine, quality of life, and depression: a population-based case-control study. Neurology. 2000;55:629–635. doi: 10.1212/wnl.55.5.629. [DOI] [PubMed] [Google Scholar]
- 54.Duru G, Auray JP, Gaudin AF, Dartigues JF, Henry P, Lantéri-Minet M, Lucas C, Pradalier A, Chazot G, Hasnaoui AE. Impact of headache on quality of life in a general population survey in France (GRIM2000 Study) Headache. 2004;44:571–580. doi: 10.1111/j.1526-4610.2004.446005.x. [DOI] [PubMed] [Google Scholar]
- 55.Lipton RB, Hamelsky SW, Kolodner KB, Steiner TJ, Stewart WF. Migraine, quality of life, and depression: a population-based case-control study. Neurology. 2000;55:629–635. doi: 10.1212/wnl.55.5.629. [DOI] [PubMed] [Google Scholar]
- 56.Kececi H, Dener S, Analan E. Co-morbidity of migraine and major depression in the Turkish population. Cephalalgia. 2003;23:271–275. doi: 10.1046/j.1468-2982.2003.00518.x. [DOI] [PubMed] [Google Scholar]
- 57.Zwart JA, Dyb G, Hagen K, Odegard KJ, Dahl AA, Bovim G, Stovner LJ. Depression and anxiety disorders associated with headache frequency. The Nord-Trondelag Health Study. Eur J Neurol. 2003;20:147–152. doi: 10.1046/j.1468-1331.2003.00551.x. [DOI] [PubMed] [Google Scholar]
- 58.Anttila P, Metsahonkala L, Mikkelsson M, Helenius H, Sillanpaa M. Comorbidity of other pains in schoolchildren with migraine or nonmigrainous headache. J Pediatr. 2001;138:176–180. doi: 10.1067/mpd.2001.112159. [DOI] [PubMed] [Google Scholar]
- 59.Hagen K, Einarsen C, Zwart JA, Svebak S, Bovim G. The co-occurrence of headache and musculoskeletal symptoms amongst 51 050 adults in Norway. Eur J Neurol. 2002;9:527–533. doi: 10.1046/j.1468-1331.2002.00451.x. [DOI] [PubMed] [Google Scholar]
- 60.Lipton RB, Bigal ME, Kolodner K, Stewart WF, Liberman JN, Steiner TJ. The family impact of migraine: population-based studies in the USA and UK. Cephalalgia. 2003;23:429–440. doi: 10.1046/j.1468-2982.2003.00543.x. [DOI] [PubMed] [Google Scholar]