How Much Does Migraine Cost?
The Cost Of Migraine To The Employer And Employee
There are numerous reasons why you need to care about migraine in the workplace. It’s the number one cause of disability for employees under fifty. 1 It’s a DEI issue. But perhaps the most compelling reason when it comes to the financials is that migraine is hiding in plain sight and is costing almost all American companies significant amounts of money.
Before we begin, let’s define some terms for clarity. Direct costs are such as prescriptions and visits to the doctor’s office and emergency room. Indirect costs occur because of lost productivity, through both absenteeism (when people call off work) and presenteeism (when people continue to work through an attack at reduced productivity.)
How much does migraine cost the United States each year?
Migraine is the second leading cause of disability on a global basis 2 . According to the Harvard Business Review, migraine costs US companies $13 billion each year 3 , whereas the Headache and Migraine Policy Forums calculated that US companies lose $78 billion a year to migraine when combining both direct and indirect costs 4 . Needless to say, this cost is not something businesses can afford to overlook.
How much does migraine cost each individual?
Migraine disease exists on a spectrum, meaning some people may experience milder symptoms rarely while others may experience severe disability on a daily basis. According to the Integrated Benefits Institute, an independent industry productivity group, the average person with migraine loses $600 in absenteeism costs each year 5 , which is frequently on the company’s tab. In additional health care costs, IBI determined that the average person with migraine spends $2,000 per year. The Harvard Business Review reports that the average worker with migraine loses 4.4 days to absenteeism and 11.4 days to presenteeism each year. 6 All together, these calculations amount to $8,600 each year.
How much does migraine cost organizations?
Migraine affects one in every four US households, so your company is almost certainly affected by migraine disease.
The Integrated Benefits Institute determined that for every 1,000 employees, each U.S company spends $84,000 in direct costs and absenteeism 7 .
These costs vary between industries, increasing up to $180,000 in the finance industry. This does not include presenteeism. Using the proven guideline that presenteeism can cost ten times that of absenteeism 8 , the presenteeism calculation would be around $6,000. Therefore, this is a significant underestimate of the true costs of migraine.
The true cost of migraine continues to escalate as these calculations do not capture the many intangible aspects of chronic disease. In severe cases, when a person experiences symptoms of migraine more than 15 days per month, they are considered to have chronic migraine. 9 Chronic migraine is associated with a higher incidence of anxiety and depression. 10 If left unaddressed, it can lead to social isolation, stigma, and take a psychological toll on the individual. 11 These elements are unaccounted for in the above figures.
According the the Headache and Migraine Policy Forum, those with chronic migraine lose about 14% of their annual productivity at work, and 20% of these workers report becoming occupationally disabled and unable to perform tasks required by their jobs 12 .
Forced early exits from the workplace are not uncommon for these employees, many of which could be prevented with the proper support.
If migraine is such a common problem, why don’t we see or hear about it?
There are several reasons why HR or leaders don’t see or hear about migraine in the workplace:
1)89% of the total of indirect costs result from presenteeism. People aren’t calling out of work because they are trying to work through their symptoms. As 90% of people cannot function normally during an attack 13 , this strategy obviously does not work well, but many people do not have other options.
2)Migraine is stigmatized. 4 out of 5 employees saying that migraine isn’t a “serious enough” reason to miss work, and slightly less than half of employers agree 14 . People living with migraine are largely aware of this stigma and thus unlikely to speak up about their condition, especially at work. Stigma leads to concealment, isolation, and “pushing through pain.”
3)Largely due to this stigma, employees fear informing supervisors or HR. Even if employees with migraine are forced to call in sick for the day, many people will not admit that migraine attacks are the true reason for their absence. Only 42% of people will include that the real reason they must call in sick is migraine disease 15 .
4)Misdiagnosis is common. 40% of Americans with migraine have not been diagnosed. Migraine can express a wide variety of symptoms. A study of sinusitis found that 9 out of 10 patients had migraine or probable migraine from a group of 100 sinusitis patients who had their diagnosis for 25 years and seen an average of 4 doctors 16 .
5)Migraine doesn’t show up in claims data. Most pharmaceutical drugs used to prevent and treat migraine attacks are repurposed from medications designed to treat other conditions like blood pressure, epilepsy, and depression. Due to the high level of misdiagnosis or underdiagnosis, generic over-the-counter pain medications may be frequently used instead of more effective migraine-specific treatments.
6)Migraine is an invisible illness. There are few obvious signs or symptoms that cannot be hidden by those who experience it. There is no cast or bandage. Others cannot see the disabling pain and nausea. When one’s job is at stake, even symptoms like vomiting can be hidden from others.
Why people with migraine can be some of your best talent
Serena Williams, John F Kennedy, Dwayne Wade- who wouldn’t want these people with migraine on their team? The disabling nature of migraine can be a driving force for success. Living with an unpredictable illness forges skills such as adaptability, resourcefulness, agility, and resilience. Knowing that you may need to rely on others at the last minute enforces teamwork, empathy, and time management skills. When you identify your staff members exhibiting these desirable traits, it is possible that they developed these abilities as a response to living through struggles like migraine disease.
How to reduce the costs of migraine
The good news is that the costs of migraine can be dramatically reduced with cost effective accommodations, education, and awareness within the organization. There have been dozens of medically-reviewed studies utilizing various migraine education and treatment programs throughout the world, and the return on investment is striking. Simple migraine education programs can increase overall productivity by 29-36% 17 . Distributing information on migraine prevention through a website, newsletter, or webinar can provide your employees with crucial knowledge on how to identify, prevent, and treat these disabling attacks. It can also help reduce stigma and encourage more people to get diagnosed and receive effective treatment.
One company provided their employees with migraine access to telemedicine visits with a nurse trained in headache medicine. Their return on investment was over 490% 18 . In the Journal of Occupational and Environmental Medicine, three US companies implemented a migraine educational program involving three informational packets and six newsletters. Their results included a 25% reduction in absentee days, a 32% reduction in presentee-affected days, and an overall 15% reduction in total costs 19 . In addition, simple accommodations are frequently inexpensive and highly effective.
These educational programs require so little effort, yet the payoff is enormous. Even more important than these costs are the improvements in quality of life for these valued employees. When companies invest in migraine management strategies, everybody wins.
Where can we find out more about the programs for employers?
Migraine at Work is a nonprofit organization that is here to help. Migraine at Work uses a scientifically proven methodology to significantly reduce the cost of migraine in your workplace and improve overall productivity. We’d be happy to discuss how we can support your unique workplace and even provide a free migraine cost assessment. Reach out today.
1) Steiner, T. J., Stovner, L. J., Vos, T., Jensen, R., & Katsarava, Z. (2018). Migraine is the first cause of disability in those under 50: will health politicians now take notice?. The journal of headache and pain, 19(1), 17. doi:10.1186/s10194-018-0846-2
2) 2021, Migraine and Disability, Headache and Migraine Policy Forum, <https://static1.squarespace.com/static/5886319ba5790a66cf05d235/t/5c65958215fcc0538b9c85de/1550161282886/HMPF_Migraine+%26+Disability+Graphic_Feb+2019.pdf>
3) Begasse de Dhaem, 2021, Migraines Are a Serious Problem. Employers Can Help., Harvard Business Review, <https://hbr.org/2021/02/migraines-are-a-serious-problem-employers-can-help >
4) Gooch, et al, 2017, The burden of neurological disease in the United States: A summary report and call to action, Annals of Neurology, <https://onlinelibrary.wiley.com/doi/10.1002/ana.24897> ;2020, Women, Migraine, and the Workplace, Headache and Migraine Policy Forum, <https://static1.squarespace.com/static/5886319ba5790a66cf05d235/t/5d07a91e2d0147000161e1bc/1560783135659/HMPF_Women%2C+Migraine+%26+Workplace_Infographic_June+2019.pdf >
5) 2018, HEALTH AND PRODUCTIVITY IMPACT OF CHRONIC CONDITIONS MIGRAINE AND OTHER HEADACHES, Integrated Benefits Institute, <https://higherlogicdownload.s3.amazonaws.com/MBGH/4f7f512a-e946-4060-9575-b27c65545cb8/UploadedImages/migraine-toolkit/IBI_Report_Health_Prod_Impact.pdf>
6) Begasse de Dhaem, 2021, Migraines Are a Serious Problem. Employers Can Help., Harvard Business Review, <https://hbr.org/2021/02/migraines-are-a-serious-problem-employers-can-help >
7) 2018, HEALTH AND PRODUCTIVITY IMPACT OF CHRONIC CONDITIONS MIGRAINE AND OTHER HEADACHES, Integrated Benefits Institute, <https://higherlogicdownload.s3.amazonaws.com/MBGH/4f7f512a-e946-4060-9575-b27c65545cb8/UploadedImages/migraine-toolkit/IBI_Report_Health_Prod_Impact.pdf>
8)Shimizu, 2021, Disability, quality of life, productivity impairment and employer costs of migraine in the workplace, Journal of Headache and Pain, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061063/>
, 2015, CLOCKING ON AND CHECKING OUT WHY YOUR EMPLOYEES MAY NOT BE WORKING AT OPTIMAL LEVELS AND WHAT YOU CAN DO ABOUT IT, Virgin Pulse, <https://gccmarketing.blob.core.windows.net/marketing-site/marketo/resources/presenteeism/us-presenteeism-whitepaper.pdf >; 2021, Begasse de Dhaem, 2021, Identification of work accommodations and interventions associated with work productivity in adults with migraine: A scoping review, Cephalagia,
9) 2021, IHS Classification ICHD-3, <https://ichd-3.org/1-migraine/1-3-chronic-migraine/ >
10) Oh, et al, 2014, Combination of anxiety and depression is associated with an increased headache frequency in migraineurs: a population-based study, BMC Neurology, <https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-014-0238-4 >
11) Lui, et al, 2020, Loneliness and Migraine Self-Management: A Cross-Sectional Assessment, Journal of Primary Care and Community Health, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268119/>
12) 2021, Migraine and Disability, Headache and Migraine Policy Forum, <https://static1.squarespace.com/static/5886319ba5790a66cf05d235/t/5c65958215fcc0538b9c85de/1550161282886/HMPF_Migraine+%26+Disability+Graphic_Feb+2019.pdf>
13) 2020, Migraine Facts, Migraine Research Foundation, <https://migraineresearchfoundation.org/about-migraine/migraine-facts/>
14) 2016, Isops, <https://www.reuters.com/brandfeatures/excedrin/employees-hide-headaches-migraines-from-supervisors>
15) 2021, Glaser, Migraine Stigma at Work is a Big Problem, Migraine Again, <https://migraineatwork.org/in_the_news/hidden-pain-migraine-stigma-at-work-is-a-big-problem/>
16) Eross, Eric, David Dodick, and Michael Eross. “The sinus, allergy and migraine study (SAMS).” Headache: The Journal of Head and Face Pain 47.2 (2007): 213-224.<https://pubmed.ncbi.nlm.nih.gov/17300361/ >
17) Begasse de Dhaem, 2021, Migraines Are a Serious Problem. Employers Can Help., Harvard Business Review, <https://hbr.org/2021/02/migraines-are-a-serious-problem-employers-can-help >
18) Shaetz,et al, 2020, Employee and Employer Benefits From a Migraine Management Program: Disease Outcomes and Cost Analysis, Headache, <https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.13933>
19) Page, et al, 2009, Evaluation of Resource Utilization and Cost Burden Before and After an Employer-Based Migraine Education Program, Journal of Occupational and Environmental Medicine, <https://journals.lww.com/joem/Abstract/2009/02000/Evaluation_of_Resource_Utilization_and_Cost_Burden.11.aspx>