BackgroundMigraine is one of the most common neurological diseases and an estimated 1.04 billion people worldwide have been diagnosed with migraine. Available data suggest that migraine is world widely associated with a high economic burden, but there is great variability in estimated costs that depends on the geographical, methodological and temporal differences between the studies. The purpose of this study was to quantify the annual direct cost of episodic migraine (EM) and chronic migraine (CM), both for the patient and for the National Health System (NHS), using data from subjects who attended an Italian tertiary headache centre. Furthermore, we evaluated comparatively the impact of gender and age on the economic burden of migraine.MethodsWe conducted a retrospective and non-interventional observational analysis of the electronic medical records of subjects with EM and CM who consecutively attended the Regional Referral Headache Centre of Rome and undergoing continuous treatment in the 2 years prior to 31 January 2019. This approach was intended to prevent distorsions due to natural fluctuations in migraine status over time. The collected data included demographic characteristics, number of specialist visits, consumption of medications, diagnostic tests, accesses in the emergency department (ED) and days of hospitalization due to the pathology.ResultsOur sample consisted of 548 patients (85.4% women and 14.6% men): 65.5% had CM and 34.5% had EM. The average annual expenditure per patient was €1482. 82.8% of the total cost (€1227) was covered by the NHS. The main item of expenditure were medications that represented 86.8% (€1286), followed by specialist visits (10.2%), hospitalizations for (1.9%), diagnostic tests for (1%) and ED visits for (0.1%). Costs were significantly higher for women than men (€1517 vs. €1274, p = 0.013) and increased with age (p = 0.002). The annual direct cost of CM was 4.8-fold higher than that of EM (€2037 vs. €427, p = 0.001).ConclusionOur results provide a valuable estimate of the annual direct cost of CM and EM patients in the specific setting of a tertiary headache centre and confirm the high economic impact of migraine on both the NHS and patients.

中文翻译：

---

慢性和发作性偏头痛患者在三级头痛中心连续治疗两年的费用

背景偏头痛是最常见的神经系统疾病之一，全世界估计有 10.4 亿人被诊断出患有偏头痛。现有数据表明，偏头痛在世界范围内与高经济负担密切相关，但估计成本存在很大差异，这取决于研究之间的地理、方法和时间差异。本研究的目的是使用参加意大利三级头痛中心的受试者的数据，量化患者和国家卫生系统 (NHS) 的发作性偏头痛 (EM) 和慢性偏头痛 (CM) 的年度直接成本. 此外，我们比较评估了性别和年龄对偏头痛经济负担的影响。方法我们对 2019 年 1 月 31 日之前连续两年就诊于罗马区域转诊头痛中心并接受连续治疗的 EM 和 CM 受试者的电子病历进行了回顾性和非干预性观察分析。防止由于偏头痛状态随时间的自然波动而导致的扭曲。收集的数据包括人口统计学特征、专科就诊次数、药物消耗、诊断测试、急诊科 (ED) 就诊次数和病理导致的住院天数。 结果我们的样本包括 548 名患者（85.4% 女性和 14.6% 男性） )：65.5% 有 CM，34.5% 有 EM。每名患者的平均年支出为 1482 欧元。NHS 承担了总成本的 82.8%（1227 欧元）。主要支出项目是药物，占 86.8%（1286 欧元），其次是专科就诊（10.2%）、住院（1.9%）、诊断测试（1%）和急诊就诊（0.1%）。女性的成本明显高于男性（1517 欧元对 1274 欧元，p = 0.013）并且随着年龄的增长而增加（p = 0.002）。CM 的年度直接成本是 EM 的 4.8 倍（2037 欧元 vs. 427 欧元，p = 0.001）。结论我们的结果提供了在特定环境下 CM 和 EM 患者的年度直接成本的有价值的估计三级头痛中心并确认偏头痛对 NHS 和患​​者的经济影响很大。女性的成本明显高于男性（1517 欧元对 1274 欧元，p = 0.013）并且随着年龄的增长而增加（p = 0.002）。CM 的年度直接成本是 EM 的 4.8 倍（2037 欧元 vs. 427 欧元，p = 0.001）。结论我们的结果提供了在特定环境下 CM 和 EM 患者的年度直接成本的有价值的估计三级头痛中心并确认偏头痛对 NHS 和患​​者的经济影响很大。女性的成本明显高于男性（1517 欧元对 1274 欧元，p = 0.013）并且随着年龄的增长而增加（p = 0.002）。CM 的年度直接成本是 EM 的 4.8 倍（2037 欧元 vs. 427 欧元，p = 0.001）。结论我们的结果提供了在特定环境下 CM 和 EM 患者的年度直接成本的有价值的估计三级头痛中心并确认偏头痛对 NHS 和患​​者的经济影响很大。