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

Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Jellestad, Pernille Linde;
ORCID
0000-0003-3634-7287
Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Carlsen, Louise Ninett;
ORCID
0000-0002-8465-8218
Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Westergaard, Maria Lurenda;
ORCID
0000-0001-8537-6960
Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Munksgaard, Signe Bruun;
ORCID
0000-0002-4810-4998
Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Bendtsen, Lars;
Affiliation
Department of Neurology, Pontificia Catolica University of Chile, Santiago, Chile
Lainez, Miguel;
Affiliation
Foundation of the Valencian Community, University Clinical Hospital, Valencia, Spain
Fadic, Ricardo;
GND
1209715945
ORCID
0000-0002-9932-1159
Affiliation
Department of Neurology, University of Essen, Essen, Germany
Katsarava, Zaza;
Affiliation
Foundation for Combatting Neurological Diseases of Childhood, Buenos Aires, Argentina
Goicochea, Maria Teresa;
Affiliation
ISalud University, Buenos Aires, Argentina
Spadafora, Santiago;
ORCID
0000-0001-6433-5887
Affiliation
Danish Headache Centre, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
Jensen, Rigmor Højland;
ORCID
0000-0003-4274-5281
Affiliation
Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy
Nappi, Giuseppe;
ORCID
0000-0003-1513-2113
Affiliation
7 Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy. 8Department of Brain and Behavioral Sciences, University of Pavia, Italy
Tassorelli, Cristina;
Affiliation
Comoestas Consortium: Grazia Sances (C. Mondino National Neurological Institute, Site Investigator), Marta Allena (C. Mondino National Neurological Institute, Site Investigator), Marina Rapsch (Department of Neurology, University of Essen, Site Investigator), Beatriz Lopez (Foundation of the Valencian Community, Site Investigator), Beatriz Shand (Department of Neurology, Pontificia Catolica University of Chile, Site Investigator)
the COMOESTAS Consortium

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)

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© International Headache Society 2018

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