An observational, cross-sectional study evaluating the humanistic and economic burden of migraine with comorbid depression across France, Germany, Italy, Spain, the UK, Brazil, and South Korea using the National Health and Wellness Survey
Gisela M. Terwindt, Alejandra E. Guevara Morel, Hasan Akcicek, Rinat Ribalov, Ying Zhang, Hanaya Raad, Kushal Modi, Neelanzana Paudel, Verena Ramirez Campos, Gabriela KivelevitchAims
Although depression commonly co-occurs with migraine, data on the combined humanistic and economic burden outside the US are limited. This study aimed to evaluate the global impact of migraine and comorbid depression.
Methods
This observational, cross-sectional study analyzed data from adults with migraine, with or without comorbid depression, across three regions (4 EU countries + UK [EU4+UK], Brazil [BR], and South Korea [SK]) from the National Health and Wellness Survey (NHWS). Sociodemographic and clinical characteristics, health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and (in)direct costs were compared within each region using descriptive, bivariate, and multivariate analyses.
Results
Overall, 1623 adults with migraine were identified in the NHWS; 35.7%, 32.9%, and 36.5% had comorbid depression in EU4+UK (N = 1073), BR (N = 331), and SK (N = 219), respectively. Across all cohorts, a higher proportion of individuals with comorbid depression experienced severe disability (Migraine Disability Assessment ≥21) compared with those without depression: EU4+UK: 60.8% vs 30.1%; BR: 65.1% vs 35.6%; SK: 48.8% vs 20.9%. Individuals with comorbid depression also had a greater overall work productivity loss (average number of days missed of work in the past 6 months) versus those with no comorbid depression (EU4+UK: 7.8 vs 2.5 days; BR: 6.1 vs 3.5 days; SK: data not available). Multivariate analyses revealed higher estimated marginal mean number of physician visits among individuals with migraine and comorbid depression versus those with no comorbid depression: EU4+UK: 12.0 vs 5.3; BR: 11.1 vs 5.1; SK: 15.0 vs 9.6. Mean total annualized direct costs (EU4+UK: €1427.7 vs €712.6; BR: $99.5 vs $60.6; SK: $1314.5 vs $729.0) and mean total annualized indirect costs (EU4+UK: €8064.9 vs €4487.5; BR: $4354.1 vs $2745.5; SK: $31,550.0 vs $19,894.0) were higher for those with comorbid depression versus those with migraine alone.
Conclusion
Across all regions, individuals with migraine and comorbid depression reported more substantial humanistic and economic burden versus individuals with migraine alone emphasizing the importance of providing appropriate treatment to mitigate the impact of migraine and comorbid depression on individuals and healthcare systems.