May 11, 2004 -- Talk to anyone who's had them: Migraines are costly. The quality-of-life costs are enormous. So is the impact on the pocketbook. In fact, a migraine sufferer's family total health-care costs often run 70% higher than families without a migraine sufferer, a new study shows.
It is the first extensive study of migraine and its impact on family health-care costs.
"Migraine is a common and costly illness that appears to have financial impact not only on the sufferers, but also on others in their families," writes researcher Paul E. Stang, PhD, an epidemiologist at the University of North Carolina School of Public Health in Chapel Hill. His study appears in the May issue of The American Journal of Managed Care.
Indeed, painful and debilitating migraine headaches run in families. They can begin in childhood. While every migraine sufferer has a different trigger, the result is the same. Overly active electrical impulses in the brain lead to inflammation of blood vessel and pain. The more inflammation there is, the more intense the migraine.
Over the years, medications such as triptans, like Imitrex, have been developed to quickly stop the headache once it begins. Also, there are older medications that can be taken to prevent a headache, such as beta-blockers (used commonly to treat heart disease) or tricyclic antidepressants.
But how does all this affect families financially? That's what Stang and his research group investigated.
Outpatient Care, Pharmacy Costs Highest
In their study, Stang and his colleagues identified 73,094 families with at least one migraine sufferer. They analyzed medical care and pharmacy costs. They also analyzed costs to employers in short-term disability, workman's compensation, and used sick days.
Among their findings:
- Health-care costs were 70% higher for families with migraine sufferers.
- If both parent and child had migraines, costs were 90% higher.
- The majority of families -- 57% -- had more than three migraine sufferers.
- Outpatient costs were 80% higher for migraine families.
- Pharmacy costs were 20% of migraine families' health-care costs vs. 15% for families without migraine sufferers.
- Health-care costs for a family were $600 higher if a child had migraines vs. a parent.
- Costs were $2,500 higher if a parent and a child had migraines.
- Adult family members of migraine sufferers had health costs that were more than twice the health-care cost of a sibling or child of a migraine sufferer.
- Triptan use increased with the number of migraine sufferers in the family: 74% of families with three or more migraine sufferers used triptans vs. 36% of families with only one migraine sufferer.
- Migraine parents used 54% more sick days and short-term disability days.
These estimates are "far higher" than the total health-care costs of other families, he notes. They are also conservative, since a substantial number of people suffer from severe headaches that can't be diagnosed as migraine, Stang says.
Switch to Preventive Drugs, Calmer Lifestyle
Michael Wasserman, MD, a pediatrician with the Ochsner Clinic Foundation in New Orleans, agreed to comment on Stang's findings. He says it's true: Migraines are becoming increasingly recognized in young and adolescent children. For families, it can be a real hardship.
"If medication cost is an issue, consider switching to generic drugs for migraine prevention," Wasserman tells WebMD. "If migraines are frequent -- more than one or two a week -- it might be worth taking something daily for prevention. You can use older generic medications for that. They could in the long run be cheaper."
Also, look at making lifestyle changes:
- Stay away from foods with caffeine -- such as chocolate and soft drinks.
- Get plenty of physical activity to relieve stress. Also, exercise helps establish "a good life rhythm" -- an easier-to-live-with balance of work and play, says Wasserman.
- Don't do athletics at night. "I see kids who have practice at 6, 7, 8 o'clock at night," he says. "That's too late. They will be too stimulated when it's time for bed."
- Get adequate sleep. Children need 10 to 12 hours. Adults need at least eight hours. "Sleep allows your body to recover from the events of the day," he says. "Children and adults both chronically don't get enough sleep."
- Try to diminish the stressors. Cut down on electronic media -- TV, videos, CDs, DVDs, and computers. "It helps slow life down," says Wasserman. So many visual images and sounds clutter our lives, our brains, and add extra stress -- whether we realize it or not, he explains.
Life is stressful enough, for both children and adults. Making it a priority to create a balanced, healthy, peaceful lifestyle could help offset the need for migraine medications.