Coverage from EHF 2019

Despite consensus among the scientific community that migraine is a prevalent and disabling condition, migraine remains both underdiagnosed and undertreated.1 In her presentation at a Teva-sponsored satellite symposium that took place during the 13th annual congress of the European Headache Federation, Prof. Patricia Pozo-Rosich (Vall d’Hebron University Hospital of Barcelona, Spain) highlighted attempts that have been made to describe the epidemiology of migraine in Europe, alongside the negative impact of migraine on individuals and society.

“We need to make sure societies and governments understand that migraine is a disease that needs to be treated.”

 – Patricia Pozo-Rosich (Vall d’Hebron University Hospital of Barcelona, Spain).  

Epidemiology of migraine in Europe

Prof. Pozo-Rosich started by outlining key studies that described the epidemiology of migraine in Europe. Migraine is not fatal and causes no outward disability, which explains why the prevalence and severity of migraine is often underestimated.2 However, every year over 136 million individuals throughout Europe experience one or more episodes of migraine that fulfils International Classification of Headache Disorders (ICHD) criteria.2 The prevalence of migraine is greater in Europe and North America than in Asia and Africa.3 In individuals aged 15–49 years, migraine is the leading cause of years lived with disability (YLD), accounting for 8.2% of all YLDs.4 Prof. Pozo-Rosich discussed the challenge of communicating important epidemiological migraine data to societies and governments, arguing that evidence needs to be translated into clear and concise messaging that can be understood and acted upon.

Impact of migraine in Europe

Prof. Pozo-Rosich further emphasised that migraine has a substantial negative impact at both an individual and societal level. The impact of migraine on individuals is considerable, with a cross-sectional analysis of survey data in France, Germany, Italy, Spain and the United Kingdom demonstrating a number of poor outcomes for patients experiencing more than three monthly headache days.5 This includes reduced functional ability, poorer health-related quality of life and decreased work productivity and attendance when compared with healthy individuals.

Migraine also presents a large and widespread financial burden. Healthcare systems are faced with the cost of primary and secondary care appointments, emergency department visits and hospitalisations.5 Evidence from Spain shows that the annual direct cost of episodic migraine per patient is €964.19, while the annual direct cost of chronic migraine per patient is €3847.29.6 When combined with the financial implications of reduced workplace attendance and productivity, the annual cost to European economies of migraine is estimated to be €18.5 billion (2012 data).7 Prof. Pozo-Rosich stated that while these figures are widely available, the scientific community needs to consider practical solutions for changing the perception of migraine among healthcare systems and employers. This includes educating clinicians, governments and workplaces about the devastating impact of migraine.

Moving forward: reducing the impact of migraine

Prof. Pozo-Rosich concluded with the positive message that treatment options are rapidly improving for migraineurs. New therapies are reducing the effect of migraine on functional ability, increasing health-related quality of life and decreasing the financial burden of migraine. However, to realise the benefits of an improved treatment landscape, it is vital that the need for new treatments is fully communicated to all relevant stakeholders.

References

  1. Stovner LJ, et al. Epidemiology of headache in Europe. Eur J Neurol. 2006;13:333–345.
  2. Stovner LJ, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17:954–976.
  3. Stovner LJ, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.
  4. Steiner TJ, et al. Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain. 2018;19:17.
  5. Vo P, et al. Patients’ perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom. J Headache Pain. 2018;19:82.
  6. Editorial Universidad de Sevilla. Impacto y situación de la Migraña en España: Atlas 2018. http://www.dolordecabeza.net/wp-content/uploads/2018/11/3302.-Libro-Atlas-Migaran%CC%83a_baja.pdf. Accessed 1 June 2019.
  7. Oleson J, et al. The economic cost of brain disorders in Europe. Eur J Neurol. 2012;19:155–162.