Migraine is a common and disabling primary headache disorder. It is the third most common disease in the world (behind dental caries) in both males and females. Globally, it is the highest cause of years lived with disability (YLDs) amongst those aged 15-49. This is generally when people are at their most productive, furthering their careers and starting families – it therefore has a huge impact on people’s career paths and the economy in general.

The indirect costs associated with migraine due to lost productivity, mainly through absenteeism and reduced effectiveness at work (presenteeism), are substantial. Yet, despite its significant socioeconomic impact, migraine is neglected: according to one study, based on data from Europe, migraine is the least publicly funded of all neurological diseases relative to its economic impact.

Although a number of studies have attempted to estimate migraine’s prevalence and associated cost burden in many countries throughout the world, relatively few have focused exclusively on the UK. The most recent study was conducted in 2003. It estimated that each year £2.25 billion is lost to migraine-related absenteeism. Being based on older data, this figure is likely to be outdated. Furthermore, it does not account for presenteeism, which is reported to have an equal or greater impact on work productivity.

The substantial indirect costs associated with migraine could be reduced significantly if it were treated and managed better: it is underdiagnosed and undertreated and public and professional understanding of the condition is poor. These problems are compounded by vague patient pathways. As such, patients that could be treated in primary care end up in secondary care. Headache is the most common neurological reason for accident and emergency attendance. This is inefficient, resulting in unnecessary waste and variation in care, contributing to the relatively small (when compared to the indirect costs), yet still significant, direct healthcare costs caused by migraine.

Better care, as well as better quality work environments comprising improved psychosocial work conditions – i.e. ‘good work’ – can reduce these costs and improve the welfare of millions of people with migraine in the UK.

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