Cost of Chronic and Episodic Migraine: a pilot study from a tertiary headache centre in northern Italy

Background: Chronic migraine (CM) has a high impact on functional performance and quality of life (QoL). CM also has a relevant burden on the National Health Service (NHS), however precise figures are lacking. In this pilot study we compared the impact in terms of costs of CM and episodic migraine (EM) on the individual and on the National Health System (NHS). Furthermore, we comparatively evaluated the impact of CM and EM on functional capability and on QoL of sufferers. Methods: We enrolled 92 consecutive patients attending the Pavia headache centre: 51 subjects with CM and 41 with EM. Patients were tested with disability scales (MIDAS, HIT-6, SF-36) and with an ad hoc semi-structured questionnaire. Results: The direct mean annual cost (in euro) per patient suffering from CM was (sic)2250.0 +/- 1796.1, against (sic)523.6 +/- 825.8 per patient with EM. The cost loaded on NHS was (sic)2110.4 +/- 1756.9 for CM, (sic)468.3 +/- 801.8 for EM. The total economic load and the different sub-items were significantly different between groups (CM vs. EM p = 0.001 for each value). CM subjects had higher scores than EM for MIDAS (98.4 +/- 72,3 vs 15.5 +/- 17.7, p = 0.001) and for HIT-6 (66.1 +/- 8.4 vs 58.7 +/- 10.1, p = 0.001). The SF-36 score was 39.9 +/- 14,74 for CM and 66.2 +/- 18.2 for EM (p = 0.001). Conclusions: CM is a disabling condition with a huge impact on the QoL of sufferers and a significant economic impact on the NHS. The adequate management of CM, reverting it back to EM, will provide a dual benefit: on the individual and on the society.