Humanistic and economic burden of nausea and vomiting among migraine sufferers

Abstract

Background

While studies have demonstrated the economic burden of migraines in terms of quality of life, health care resource use (HRU), and costs, there exists a notable paucity of data comparing such outcomes among migraineurs with nausea and vomiting (N/V) and those without. The current study aimed to address this gap.

Methods

This was a retrospective study using data from the 2013 US National Health and Wellness Survey, a cross-sectional, internet-based survey. Respondents self-reported their migraine with or without N/V along with demographics and outcomes including depression (Patient Health Questionnaire total score; PHQ-9), sleep problems (11-item total score of sleep problems), HRU (number of physician visits, emergency room [ER] visits, and hospitalizations) and Work Productivity and Activity Impairment-General Health Scale (WPAI-GH), and associated mean annual costs. Generalized linear models, adjusting for covariates, assessed the burden of N/V on all outcomes.

Results

Among all migraineurs (N=7,855), 73.4% were female, mean age was 41.82 years old, and 57.6% reported experiencing N/V. Adjusting for covariates, migraineurs with N/V vs without N/V had higher mean PHQ-9 scores (7.91 vs 7.02, p<0.001) and mean sleep problems (3.29 vs 2.64, p<0.001). Mean ER visits were more frequent among migraineurs with N/V than those without N/V (0.48 vs 0.38, p=0.001). This difference translated into a 26.3% increase in estimated mean ER costs (N/V=US$1,499 vs without N/V=US$1,187, p=0.002). Mean percentage activity impairment was higher in migraineurs with N/V than in those without N/V (37.73% vs 35.12%, p=0.002) and migraineurs with N/V had higher work productivity loss costs (N/V=US$10,344 vs without N/V=US$9,218, p=0.016).

Conclusion

Migraine patients with N/V reported worse depression, sleep problems, and activity impairment, and higher ER visits than those without N/V. Migraine with N/V was also associated with an increase in mean annual ER visit costs and work productivity loss costs. Study findings suggest unmet needs with current treatment options for migraine patients with N/V.

Keywords:

• migraine
• nausea
• vomiting
• depression
• work productivity
• healthcare resource use
• costs

Acknowledgments

The authors acknowledge the literature review and editing assistance of Errol J Philip, PhD, on behalf of Kantar Health, with funding from Teva Pharmaceuticals. Portions of this research were presented as a Poster (PF52: “Humanistic and Economic Burden of Nausea and/or Vomiting among Migraine Sufferers: Results from the National Health and Wellness Survey”) at the 57th Annual Scientific Meeting of the American Headache Society, and published in “Headache: The Journal of Head and Face Pain,” June, 2015. http://onlinelibrary.wiley.com/doi/10.1111/head.12600/abstract.

Author contributions

Kavita Gajria and Sanjay K Gandhi conceptualized the rationale and design of the study. Lulu K Lee and Natalia M Flores participated in statistical analyses and interpretation of study results. All authors participated in interpretation of the study results, revisions of earlier manuscript drafts, and approved the final manuscript.

Disclosure

Kavita Gajria, Ernesto Aycardi, and Sanjay Gandhi are full-time employees of Teva Pharmaceuticals, which provided funding for the study. Lulu K Lee is a full-time employee of Kantar Health, which received funding from Teva Pharmaceuticals to conduct this study. Natalia M Flores was an employee of Kantar Health when this study was conducted. The authors report no other conflicts of interest in this work.