Hazard Elisabeth, Munakata Julie, Bigal Marcelo E, Rupnow Marcia F T, Lipton Richard B
IMS Consulting, Falls Church, VA 22046, USA.
Value Health. 2009 Jan-Feb;12(1):55-64. doi: 10.1111/j.1524-4733.2008.00404.x. Epub 2008 Jul 30.
Migraine is often perceived as a low-impact condition that imposes a limited burden to society and the health-care system. This study reviews the current understanding of the burden of migraine in the U.S., the history of economic understanding of migraine treatment and identifies emergent trends for future studies evaluating clinical and economic outcomes of migraine treatment.
This study traced the history of economic articles published on migraine by performing a literature search using PubMed MEDLINE database and ancestral searches of relevant articles. The intention was not to provide an exhaustive review of every article or adjudicate between studies with different findings.
Migraine affects millions of individuals worldwide, generally during the most productive years of a person's life. Studies show that migraineurs are underdiagnosed, undertreated, and experience substantial decreases in functioning and productivity, which in turn translates into diminished quality of life for individuals, and financial burdens to both health-care systems and employers. Economic evaluations of migraine therapies have evolved with new clinical developments beginning with cognitive-behavioral therapy, introduction of triptans, concern over medication overuse, and emergence of migraine prophylaxis. Now recent clinical studies suggest that migraine may be a progressive disease with cardiovascular, cerebrovascular, and long-term neurologic effects.
Migraine imposes a substantial burden on patients, families, employers and societies. The economic standards by which migraine and treatment are evaluated have evolved in response to clinical developments. Emerging evidence suggests that migraine is a chronic and progressive disease. If confirmed, approaches to acute and prophylactic treatments and economic evaluations of migraine treatment may require major reconsideration.
偏头痛常被视为一种影响较小的病症，对社会和医疗保健系统造成的负担有限。本研究回顾了目前对美国偏头痛负担的认识、偏头痛治疗经济认识的历史，并确定了未来评估偏头痛治疗临床和经济结果的研究的新趋势。
本研究通过使用PubMed MEDLINE数据库进行文献检索以及对相关文章进行追溯检索，追溯了发表的关于偏头痛的经济类文章的历史。目的不是对每篇文章进行详尽的综述，也不是在有不同研究结果的研究之间进行裁决。
偏头痛影响着全球数百万人，通常是在一个人生命中最具生产力的时期。研究表明，偏头痛患者诊断不足、治疗不足，功能和生产力大幅下降，这反过来又导致个人生活质量下降，给医疗保健系统和雇主带来经济负担。随着新的临床进展，偏头痛治疗的经济评估也在不断发展，从认知行为疗法开始，曲坦类药物的引入，对药物过度使用的关注，以及偏头痛预防的出现。现在最近的临床研究表明，偏头痛可能是一种具有心血管、脑血管和长期神经影响的进行性疾病。
偏头痛给患者、家庭、雇主和社会带来了巨大负担。评估偏头痛及其治疗的经济标准随着临床进展而演变。新出现的证据表明，偏头痛是一种慢性进行性疾病。如果得到证实，偏头痛的急性和预防性治疗方法以及偏头痛治疗的经济评估可能需要重新进行重大考量。
