In contemplating the burden of migraine, it is useful to distinguish individual burden and societal burden. The individual burden is determined by symptoms during attacks, by anticipation of symptoms between attacks, by the decrement that migraine produces in quality of life in people who suffer with migraine versus the general population and in the lost economic opportunity. There is also evidence showing that migraine reduces family, social and recreational activities. Looking at the societal burden, it is traditional to express this burden in economic terms by distinguishing between direct costs and indirect costs. Direct costs refer primarily to the cost of medical care. Indirect costs refer primarily to the impact the illness has on work and on function in other domains. For work, it’s useful to distinguish absenteeism from reduced effectiveness. With regard to indirect costs, which are the primary costs of migraine, migraine sufferers from the general population required 3.8 days of bed rest for men and 5.6 days of bed rest for women per year on average. Projecting to the US population, that means that migraine causes a total of 112 million bedridden days per year. Migraine costs American employers about $13 billion per year due to missed work and also reduced function while at work. Patients between the ages of 30 and 49 incurred the greatest indirect costs relative to younger and older workers, which is not surprising given the epidemiologic profile of disease. The burden of disease is the target for effective therapy. Hu HX, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med . 1999;159(8):813-818. Lipton RB, Stewart WF, Simon D. Work-related disability: results from the American Migraine Study. Cephalalgia . 1996;16:231-238. Hu HX, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med . 1999;159(8):813-818.
Migraine At Work: An Introduction
Migraine/Headache at Work: An Introduction Donna Ryan, Information Officer Migraine Association of Ireland
Migraine and other Headache Disorders• 90% will suffer from headache• Migraine – most common disabling headache disorder • 12-15% of population • Average attack rate – 2 per month • 10% patients get weekly attack • 4% have Chronic Migraine = Migraine on 15+ days per month• Ranked by the World Health Organisation as the 12th leading cause of disability worldwide amongst women and 19th overall Migraine is not just a headache!
CONSEQUENCES OF MIGRAINEOn The IndividualOn The FamilyOn Work Functioning
Workforce Disability200,000 workforce migraineurs37% miss more than 5 days per yearfrom work92% say attacks affect jobperformanceUnemployment greaterCosts the economy €252 million peryear
Key Issues* EXCLUSION/ISOLATION* STIGMA/LACK OF UNDERSTANDING* VULNERABILITY* FINANCIAL HARDSHIP
Quality of Life Survey 2003 Migraine reduces my job satisfaction
Quality of Life Survey 2003My employer is sympathetic towards the impact migraine has on me
Days missed from work by Irish migraineurs per annum16-20 days2% 21+ days 5% 11 9% -15 d a ys 6-10 days 0-5 days 21% 63%
Everybody benefits if migraine is properly managed:Benefits to employees• Increased job satisfaction• Better health and well-being• Better social and family lifeBenefits to employers• Increased productivity• Less absenteeism• Positive workplace environment Increased understanding about migraine + Improved migraine management = More content and productive workforce.