Impatto clinico ed economico dell’emicrania in Italia: un’analisi di real-world evidence

Introduction: This retrospective observational analysis evaluated the clinical, demographic, and economic burden
of migraine patients in real-world Italian clinical practice.
Methods: A retrospective observational analysis was conducted using Italian administrative databases, involving
approximately 12 million beneficiaries. All adult patients with at least one hospital discharge diagnosis of
migraine (ICD-9-CM = 346) or at least one prescription for migraine-specific medications (ATC = N02C) between
January 2010 and July 2024 were included. The index-date was defined as the first occurrence of either inclusion
criterion. Patients were characterized at baseline for demographic variables and comorbidity profile. Direct
healthcare costs covered by the National Health Service (SSN) were estimated per patient for the 12 months
pre- and post-index-date. An exploratory analysis of total direct healthcare costs was performed, including both
migraine-specific and potentially migraine-related costs, over three-time horizons (12, 36, and 60 months before
the index-date). Analyses were stratified by sex.
Results: A total of 185,737 patients were included; 72.1% were female, with a mean age of 47 years. Of the
patients, 75.3% had no relevant comorbidities (Charlson Comorbidity Index = 0). The total healthcare costs per
patient were estimated at € 898 and € 1,179 in the 12 months before and after the index-date, respectively. Hospitalization
and outpatient service costs potentially related to migraine were approximately ten times higher than
migraine-specific costs.
Conclusions: Migraine imposes a significant economic burden, particularly among the female population. Exploratory
analyses revealed that potentially migraine-related costs were higher than migraine-specific costs, suggesting
a delay in diagnosis and appropriate management.