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Why Does Migraine Not Appear in Claims Data?

Migraine affects 1 in every 6 US adults. It’s the number two leading cause of disability in the US  working age group.(1) According to an independent industry group, The Integrated Benefits Institute, for every 1,000 employees, each U.S company spends $84,000 in direct costs and absenteeism.(2) 

If migraine has such a large cost, it’s reasonable to ask why it is not obvious. Why are there not a steady stream of migraine complaints? Why doesn’t it show up in claims data? You may begin to wonder if perhaps your organization is different from others that have this problem.

The answer is almost certainly no. Migraine is still an issue. 

There are several reasons why migraine does not prominently appear in insurance claims data.

1.) 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. In fact, until 2018, there was not a single drug specifically designed for the prevention of migraine. While these medications will often appear in the claims data, the diagnosis of migraine may not.

2.) Migraine is largely genetic. If people grew up in families affected by migraine, they are often taught to live with it. Their relatives may have visited doctors in previous decades where effective options simply were not available. The misguided attitude  of, “Don’t bother wasting your time with doctors because they can’t help you,” gets passed down through generations. This information is entirely out of date, and things are very different now than they were even just five years ago. In these situations, employees are still being affected by migraine, but this disease and its productivity toll remains invisible to the company.

3.) 40% of people living with migraine are undiagnosed.(3) Many employees may not even realize they have migraine. They may incorrectly assume the issue lies in other areas like their sinuses or their neck.(4) Generic over-the-counter pain medications are frequently utilized. Employees are wrongly treating the myriad of symptoms, without addressing the cause. This ineffective treatment sets up these employees for worsening their disease, putting them at risk for migraine chronification.(5) It is also another reason why migraine remains hidden. 

Outside of the claims data, there’s many additional reasons why you may not have noticed migraine in your office.

1.) 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 (6), this strategy obviously does not work well, but many people do not have other options. Especially those employees with frequent migraine attacks, calling out every time an attack occurs would simply not be possible. So employees come to work suffering, and productivity plummets. 

Many employees with migraine may need to fake being well enough to work through the day. Most of the cost of migraine in the workplace is due to presenteeism. They are present at work, but not operating at full capacity. 

2.)  Even if they are forced to call out for the day, many employees will not admit that migraine attacks are the true reason for their absence. Due largely to the stigma of migraine, only 42% of people will include that the real reason they must call in sick is migraine.(7) 

3.) Employees do not feel comfortable disclosing this disease. People incorrectly assume migraine is “just a headache,” and employees should be able to take a simple over-the-counter pill and continue on with their day. Others assume a migraine attack is a simple excuse to get out of obligations. In reality, migraine is a debilitating neurological disease with dozens of disabling symptoms. Employees with migraine want and need to keep their jobs, but without the proper support, many are forced to sacrifice their careers. 

 

The good news is that the heavy cost of migraine in the workplace can be avoided.

Even better news is that it’s surprisingly easy to help mitigate these costs. Simple education programs require little effort and money, and have an incredible return on investment, which has been proven in several case studies and published in research journals. Furthermore, accommodations for those with migraine tend to be inexpensive. Supporting your employees with migraine is great for them, and even better for the business. Get started today by contacting us today.

 

 


1- Steiner, et al, 2019, Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019, The Journal of Headache and Pain, <https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-01208-0#:~:text=02%20December%202020-,Migraine%20remains%20second%20among%20the%20world's%20causes%20of%20disability%2C%20and,young%20women%3A%20findings%20from%20GBD2019&text=The%20capstone%20papers%20on%20the,in%20Lancet%20on%20October%2017th.

2- 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>

3- 2016, Headache Disorders, World Health Organization, <https://www.who.int/news-room/fact-sheets/detail/headache-disorders>

4- 2021, Migraine, National Headache Foundation, <https://headaches.org/2012/10/25/migraine/#:~:text=The%20pain%20of%20migraine%20is,to%20anything%20touching%20their%20head.>

5- Torres-Ferrús, et al, 2020, From transformation to chronification of migraine: pathophysiological and clinical aspects, The Journal of Headache and Pain, <https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-01111-8>

6- 2021, About Migraine- Migraine Facts, Migraine Research Foundation, <https://migraineresearchfoundation.org/about-migraine/migraine-facts/>

7- https://migraineatwork.org/in_the_news/hidden-pain-migraine-stigma-at-work-is-a-big-problem/