Economic benefits of treating medication-overuse headache – results from the multicenter COMOESTAS project

Author:

Jellestad Pernille Linde1,Carlsen Louise Ninett1,Westergaard Maria Lurenda1ORCID,Munksgaard Signe Bruun1ORCID,Bendtsen Lars1,Lainez Miguel2,Fadic Ricardo3,Katsarava Zaza4,Goicochea Maria Teresa5,Spadafora Santiago6,Jensen Rigmor Højland1,Nappi Giuseppe7,Tassorelli Cristina78ORCID,

Affiliation:

1. Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark

2. Department of Neurology, Pontificia Catolica University of Chile, Santiago, Chile

3. Foundation of the Valencian Community, University Clinical Hospital, Valencia, Spain

4. Department of Neurology, University of Essen, Essen, Germany

5. Foundation for Combatting Neurological Diseases of Childhood, Buenos Aires, Argentina

6. ISalud University, Buenos Aires, Argentina

7. Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy

8. Department of Brain and Behavioral Sciences, University of Pavia, Italy

Abstract

Background Medication-overuse headache is a costly disease for individuals and society. Objective To estimate the impact of medication-overuse headache treatment on direct and indirect headache-related health care costs. Methods This prospective longitudinal study was part of the COMOESTAS project (COntinuous MOnitoring of Medication Overuse Headache in Europe and Latin America: development and STAndardization of an Alert and decision support System). Patients with medication-overuse headache were included from four European and two Latin American headache centers. Costs of acute medication, costs of health care services, and measurements of productivity were calculated at baseline and at 6-month follow-up Treatment consisted of overused drug withdrawal with optional preventive medication. Results A total of 475 patients (71%) completed treatment and were followed up for 6 months. Direct health care costs were on average reduced significantly by 52% ( p < 0.001) for the total study population. Significant reductions were seen in both number of consumed tablets (−71%, p < 0.001) and number of visits to physicians (−43%, p < 0.001). Fifty percent of patients reduced their number of consumed tablets ≥ 80%. Headache-related productivity loss, calculated either as absence from work or ≥ 50% reduction of productivity during the workday, were reduced by 21% and 34%, respectively ( p < 0.001). Conclusion Standardized treatment of medication-overuse headache in six countries significantly reduced direct health care costs and increased productivity. This emphasizes the importance of increasing awareness of the value of treating medication-overuse headache. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056)

Funder

COMOESTAS project

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

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