Economic burden of medication-overuse headache in Iran: direct and indirect costs
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ORIGINAL ARTICLE
Economic burden of medication-overuse headache in Iran: direct and indirect costs Mansoureh Togha 1,2 & Fatemeh Nadjafi-Semnani 3 & Fahimeh Martami 2 & Zahra Mohammadshirazi 4 & Niusha Vahidpour 5 & Ali Akbari-sari 6 & Rajabali Daroudi 6 Received: 30 June 2020 / Accepted: 8 September 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background and objective Medication-overuse headache (MOH) as a secondary chronic headache imposes a considerable burden on both individuals and societies. Nevertheless, little is known about the burden of MOH in Iran. Therefore, in the current study, we aimed to quantify the annual cost of MOH among Iranian patients. Methods In this cross-sectional study, 84 patients were recruited. Demographic data, headache attack characteristics, related disability, and information about the economic burden of MOH were collected through face-to-face interview. Direct medical and nonmedical costs as well as indirect costs were included in our cost analysis. The prevalence-based approach was applied to estimate the economic burden of MOH. Results We found that MOH patients in Iran spend averagely $1046 for medical services, $132 for nonmedical services, and $1432 due to lost productivity per year. The per-person annual cost of MOH was US$2610, and the total annual cost for Iran was $10,179,000,000, with direct and indirect cost accounting for 45% and 55%, respectively. Conclusion MOH leads to substantial healthcare costs and significant loss of productivity in Iran. Therefore, raising awareness in this area especially for policymakers can use in future health planning and lead to resource allocation in the field of disabling type of headache disorders such as MOH. Our findings also provide a different insight into the burden of MOH, which are likely closer to the actual costs in middle- and low-income countries, and also it could be a sample of such a study in western Asia. Keywords Headache . Medication-overuse headache . MOH . Cost . Burden
Mansoureh Togha and Fahimeh Martami are equally first authors. * Mansoureh Togha [email protected] 1
Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
2
Headache Department, Neurology Ward, Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3
Eye Research Center, The Five Senses Institute Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
4
Shariari Hospital, Tehran University of Medical Sciences, Tehran, Iran
5
Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abbreviations GBD Global Burden of Disease DALYs Disability-adjusted life-years MOH Medication-overuse headache TTH Tension-type headache MIDAS Migraine Disability Assessment test VAS Visual analogue scale NSAIDs Nonsteroidal anti-inflammatory drug
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