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The Medical Costs of Migraine
and Comorbid Anxiety and Depression
Jacqueline Pesa, Ph.D., Maureen J. Lage, Ph.D.
Posted: September 2004
Objective: To examine the direct
medical costs associated with migraine, when diagnosed alone and
in conjunction with anxiety and/or depression in adults and
Background: Migraine is a common disorder that
can often be accompanied by comorbid anxiety and/or depression.
Given the prevalence of migraine and the likelihood for comorbid
conditions, it is not surprising that migraine is extremely
costly for society.
Methods: Migraine cohorts were identified in a
1999-2000 database capturing inpatient, outpatient, and
prescription drug services from approximately 45 large
employers. Four cohorts of adults (migraine only, migraine and
anxiety, migraine and depression, migraine and both conditions),
and two cohorts of children (migraine only, migraine and anxiety
and/or depression), were compared to respective "healthy" cohorts.
Results: Compared to nonmigraineurs, adults and
children with migraine had significantly higher total direct medical
costs in all examined categories ($7,089 vs. $2,923 adults; $4,272 vs.
$1,400 children). For adults, the presence of depression and/or
anxiety along with migraine equated to significantly greater total
direct medical costs when compared to their matched healthy cohorts
($12,642 vs. $5,179 anxiety; $11,290 vs. $3,135 depression). Children
with migraine and either anxiety or depression (or both) incurred an
average of $9,875 in total direct medical costs as compared with
only $1,165 for healthy comparators. For children and adults, the
presence of comorbid anxiety or depression was associated with
significantly higher medical costs when compared to migraine alone.
Conclusions: This analysis quantifies the
economic impact of a migraine diagnosis for both adults and
children. The results of this analysis demonstrate that
individuals identified as migraineurs have significantly
higher medical costs than healthy comparators, with or
without comorbid anxiety and/or depression. This study also
suggests that clinicians should be aware that while proper
treatment of migraine with effective acute and prophylactic
therapy is important, attention must also be directed to