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Indirect Cost Burden of Migraine in the United States

Hawkins, Kevin PhD; Wang, Sara PhD; Rupnow, Marcia F. T. PhD

Journal of Occupational and Environmental Medicine: April 2007 - Volume 49 - Issue 4 - p 368-374
doi: 10.1097/JOM.0b013e31803b9510
Original Articles

Objective: The purpose of this study was to determine the indirect cost burden associated with migraine.

Methods: Data were obtained from Thomson-Medstat's Health and Productivity Management (HPM) database for the 2002 through 2003 calendar years. The migraine cohort was composed of patients who had a diagnosis of migraine or migraine-specific abortive prescription medication, or both. A control cohort of patients without migraine was matched to patients in the migraine cohort. The average annual indirect burden of illness (BOI) of migraine and a national indirect BOI were estimated.

Results: Annual indirect expenditures were significantly higher in the migraine group compared with the control group ($4453 vs $1619; P < 0.001). The national annual indirect BOI, excluding presenteeism, was estimated to be $12 billion (mostly attributed to absenteeism).

Conclusions: Migraine imparts a substantial indirect cost burden. Projected to a national level, this amounts to an annual cost to US employers of approximately $12 billion.

From Thomson Medstat (Dr Hawkins, Dr Wang), Cambridge, MA; and Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ (Dr Rupnow).

CME Available for this Article at

The 1994 US$ to 2004 US$ conversions were performed using inflation algorithms from

This research was supported by Ortho-McNeil Janssen Scientific Affairs, LLC.

Address correspondence to: Sara Wang, PhD; Thomson Medstat, 150 Cambridge Park Dr, Second Floor, Cambridge, MA 02140; E-mail:

©2007The American College of Occupational and Environmental Medicine