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2011 Annual Meeting Abstracts

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A Medico-Economic Analysis of Surgical Treatment of Migraine Headaches
Carey Faber, AB, Ryan Garcia, MD, Janine Davis, RN, Bahman Guyuron, MD.
Case Western Reserve University, Cleveland, OH, USA.

PURPOSE: Surgical treatment of migraine headaches has been demonstrated to be effective and lasting. The purpose of this study is to perform an analysis of both direct and indirect costs associated with migraine headaches before and after migraine surgery. We also aimed to evaluate any postoperative changes in patient participation in daily activities.
METHODS: Eighty-nine patients enrolled in a clinical trial for migraine surgery completed a Migraine Specific Questionnaire (MSQ), a Migraine Disability Assessment Programme (MIDAS) questionnaire, and a financial cost report pre-operatively and post-operatively. Endpoints for this study were to document the changes in the median costs and changes in reported participation of daily activities at 5 years postoperative.
RESULTS: Mean patient age was 45 years (range 21-63 years) and mean follow-up was 63.03 months (range, 56.9-72.63 months). There was a median cost reduction for migraine medication expenses of $1,997.26 dollars per year. The alternative treatment expenses were reduced by $450 dollars per year. Patients who underwent migraine surgery reported 3 fewer annual primary care doctor visits per year for the specific treatment of migraine headaches which resulted in a median cost reduction of $320 dollars per year. Patients missed a median of 8.5 fewer days of work or childcare per year after surgery. Patients reported a median of $1,525.00 income regained per year postoperatively due to the prevention of loss of time from work. The mean total cost spent for any form of treatment of migraine headaches was $9632.39 ± $1256.40 per year prior to surgery which declined significantly to $2237.40 ± $435.2 (p<0.0001) at 5 years postoperative. The mean surgical payment including the outpatient facility and anesthesia fees was approximately $9750. Significant improvements in all aspects of the MSQ and MIDAS questionnaire were demonstrated.
CONCLUSION: Surgical deactivation of migraine trigger sites has proven to be an effective method for the treatment of severe migraine headaches. This study illustrates that the surgical treatment is a cost effective modality with reduced direct and indirect costs spent toward migraine treatment at 5 years postoperative. Patients experience improvements in the performance of and participation in activities of daily living.

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