MIGRAINE
Migraine Is More Than A Headache
Migraine is a neurological condition that can cause severe head pain, nausea, and sensitivity to light or sound. Migraine can significantly affect daily life and, when symptoms are not effectively managed, may contribute to increased health care utilization. Using its commercial claims data warehouse, Missouri Health Value Collaborative (MHVC) explored migraine prevalence, emergency department utilization, follow-up care, and treatment patterns among commercially insured adults in the St. Louis and Kansas City metropolitan areas from 2019 to 2023. MHVC’s analysis suggests migraine may be underdiagnosed and is associated with high emergency department use and gaps in follow-up care.
National prevalence estimates suggest approximately 12–14% of adults experience migraine, while MHVC’s claims-based analysis found that 3.5% of commercially insured adults living in the St. Louis and Kansas City metropolitan areas had a migraine diagnosis in 2023, suggesting underdiagnosis. Migraine prevalence was higher among women, at 5.1% compared with 1.1% among men, and adults ages 45–49 were the most likely to have a migraine diagnosis.
Emergency department (ED) utilization was substantially higher among patients with migraine. In 2023, patients with a migraine diagnosis had 465 ED visits per 1,000 members compared with 156 visits per 1,000 among those without a migraine diagnosis. About one-quarter of migraine patients visited the ED at least once during the year, while more than 3% had four or more ED visits. Follow-up care also showed opportunities for improvement: 46% of migraine patients saw a primary care provider within 30 days after an ED visit, 62% saw a primary care provider within 90 days, and only 11% saw a neurologist or selected pain specialist within 90 days.
Treatment gaps were also identified. About 44% of migraine patients across St. Louis and Kansas City had no migraine prescription fill identified in pharmacy claims in 2023. In addition, opioid prescription fill rates have declined overall since 2019 but remained nearly three times higher among patients with migraine than among those without migraine in 2023. Early support, appropriate follow-up care, and better access to treatment may improve wellbeing and help reduce avoidable health care use and associated costs.
Check out the infographic for more information!
MHVC thanks Champion for Health Care Value, AbbVie, for contributions to this project and ongoing support of MHVC's community work.
