Headache Claims-Based Prevalence and Healthcare Utilization among Healthcare Employees
Olivia Begasse De Dhaem1, Daod Pak2, Brian Grosberg3
1Department of Neurology, University of Connecticut, Institute for Headache and Brain Health, 2Hartford Healthcare, 3Hartford HealthCare Headache Center
Objective:
Assess headache claims-based prevalence and cost among employees of a healthcare organization
Background:
Migraine is a leading cause of productivity loss in the workplace, which tends to be overlooked due to stigma and concealment, the fact that 89% of migraine-related productivity loss stems from presenteeism (vs absences), and the relative low headache claims. Raising headache awareness in the workplace sometimes comes with the fear of increasing diagnosis and hence evaluation and management costs to self-insured employers.
Design/Methods:
IRB-approved, retrospective study of one year of medical and pharmacy claims data of all employees (not their dependents) continuously enrolled on their employer health insurance plan. ICD10 codes were used to identify 1) claimants with headache disorders and 2) headache-related medical claims, 3) medications prescribed for headache.
Results:
In 2023, the claims-based prevalence of headache is 5.8% (945 of 16,395 continuously enrolled employees). The total medical and pharmacy costs per member per month (PMPM) of claimants with headache ($1,061 and $579, respectively) are higher than those of claimants without headache ($575 and $268). In terms of headache-related claims PMPM, the medical and pharmacy costs are $135 and $158, respectively. The headache-specific medical claims represent less than 1% of total cost to the employee health plan.
Conclusions:
Even in a healthcare organization, the claims-based prevalence of headache among employees is low (5.8%) compared to the prevalence of headache in the general population. The prevalence of migraine alone is 15.9%. Headache disorders are underdiagnosed and undertreated in the workplace. Consistent with prior studies, the total healthcare costs of headache claimants are higher than those of claimants without headache and the difference is not fully accounted for by headache-specific claims. The healthcare utilization (medical and pharmacy) cost of headache diagnosis and treatment represents a small fraction of total costs covered by the employee health plan.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.