Employers who recognize the impact of migraine may help to improve workplace productivity

May 03, 2007

Boston, Mass. -- May 3, 2007 -- Migraines take a toll on employers as well -- up to $28.7 billion in annual direct and indirect healthcare costs can be attributed to migraine-related losses in productivity. Data presented today at the 59th Annual Meeting of the American Academy of Neurology (AAN) in Boston, Mass., reinforced the benefit for employers to acknowledge and assess the impact of migraine to potentially improve workplace productivity. The data also suggested workers consider potential treatment options that may help them prevent or reduce the frequency of migraine attacks.

The first of three analyses sponsored by Ortho-McNeil Neurologics, Inc. found that employers who actively screen for migraine may help identify those undiagnosed with the condition. The researchers also evaluated the total burden of migraine in the workplace and found that more than 50 percent of the migraine sufferers surveyed experienced moderate to severe disability due to the condition, often affecting job performance and leading to missed workdays. The third analysis examined the impact of preventive treatment on workers who suffer from frequent migraines and suggested that use of TOPAMAX® (topiramate) may lead to fewer missed workdays and improve workplace productivity.

"Migraine can have a significant impact in the workplace," said study investigator Jennifer Lofland, PharmD, MPH, Ph.D., project director, Department of Health Policy, Jefferson Medical College of Thomas Jefferson University.

"If migraine can be effectively managed during the workday, it may lead to cost savings for employers over the long run. One approach patients may want to consider is taking a preventive medication to help reduce the frequency of migraine attacks and potentially lead to more migraine-free days."

Screening for Migraine in the Workplace

Researchers determined that the use of a brief, online screener may help to detect those undiagnosed for migraine in an employer setting and is easy to administer. Researchers from the Center for Health Economics and Policy, United BioSource Corporation, developed an online tool based on a validated screener (Lainez et al.), to help determine the prevalence of migraine in the workplace.

Three large employers in the U.S. were recruited to participate in the online study that compared the screening results with patient-reported migraine diagnoses. The results revealed that more than 90 percent of employees who reported a previous migraine diagnosis screened positive for the condition. In addition, nearly 30 percent of respondents who met the screener criteria for migraine were undiagnosed.

Burden of Migraine in Employer Settings

In the same study, researchers aimed to assess the total burden of migraine in the workplace including impact on productivity. The researchers compared employee responses to the online screener with results from a baseline survey investigating migraine frequency and severity, treatment patterns and total impact of migraine at work during a three-month period.

Study results revealed that more than 50 percent of people with migraines experienced moderate to severe disability in the previous three months due to the condition. On average, one workday was missed per employee due to migraine, while the average days worked while having a migraine was 8.9 days. Direct medical costs were $200,410 per 1,000 migraine sufferers and indirect costs, including absenteeism (hours absent from work) and presenteeism (hours worked with migraine with reduced efficiency), were $404,660 per 1,000 migraine sufferers. From a treatment perspective, more than 70 percent of respondents reported having frequent and/or disabling migraines and may be candidates for preventive treatment. However, only 15 percent were taking a daily preventive migraine therapy. Forty-eight percent reported taking a prescription medication for migraine symptom relief, and 79 percent reported taking a non-prescription medication.

TOPAMAX Improved Workplace Productivity -- Pooled Results from Three Trials

Results of this data analysis conducted by Philadelphia's Thomas Jefferson University, suggested that 100 mg per day of TOPAMAX, approved by the U.S. Food and Drug Administration (FDA) for migraine prevention in adults, may help to improve workplace productivity. Researchers examined pooled results from three different trials, including data recently published in The Journal of Occupational and Environmental Medicine. The findings suggested productivity improved more than two-fold among workers after beginning treatment with TOPAMAX (total lost productivity time was 13.5 hours per month prior to TOPAMAX therapy vs. 5.1 hours per month following TOPAMAX therapy).

Migraine sufferers taken from three previous phase III clinical trials were evaluated as part of the study. All were clinically diagnosed with migraine and experienced at least three to 12 migraines per month. In this analysis, the respondents completed a five-item survey each time they experienced a migraine attack, which evaluated absenteeism and presenteeism. The analysis was limited to respondents from the clinical trials who were employed, and the researchers only captured lost work hours observed during episodes of migraine.

About Migraine

Migraine is a chronic, debilitating condition that is under-diagnosed, undertreated and misunderstood. Approximately 30 million Americans suffer from migraines, and less than half are properly diagnosed with the condition. Migraines most commonly occur between the ages 30 and 49, a time when people are actively involved in the workforce. Recently, the American Migraine Prevalence and Prevention (AMPP) Study showed that almost 98 percent of people with frequent migraines take medications, but a large majority reported their lives are still negatively impacted by the pain and disability associated with migraine. In addition, approximately 40 percent of frequent migraine sufferers could benefit from preventive therapy, yet only 13 percent typically are on a migraine preventive medication.

TOPAMAX is approved for migraine prevention in adults only. TOPAMAX is not for the acute treatment of migraines.


Serious risks associated with TOPAMAX include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis), and hyperventilation (rapid, deep breathing) or fatigue. More severe symptoms of metabolic acidosis could include irregular heartbeat or changes in the level of alertness. Chronic, untreated metabolic acidosis may increase the risk for kidney stones or bone disease. Your doctor may want to do simple blood tests to measure bicarbonate levels.

Other serious risks include increased eye pressure (glaucoma), decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion, and difficulty concentrating. Tell your doctor immediately if you have blurred vision or eye pain. More common side effects are tingling in arms and legs, loss of appetite, nausea, diarrhea, taste change and weight loss. Tell your doctor about other medications you take.
Please see full U.S. prescribing information available at www.topamax.com

About Ortho-McNeil Neurologics, Inc.

Headquartered in Titusville, N.J., Ortho-McNeil Neurologics, Inc., focuses exclusively on providing solutions that improve neurological health. The company currently markets products for Alzheimer's disease, epilepsy, and acute and preventive migraine treatment. Ortho-McNeil Neurologics, Inc., in conjunction with internal and external research partners, continues to explore new opportunities to develop solutions for unmet healthcare needs in neurology.

About Jefferson Medical College

The Department of Health Policy at Jefferson Medical College is committed to conducting research and education programs that will contribute to the quality, safety, and cost-effectiveness of health care. The Department's activities are meant to inform decisions made by government policy makers, providers, payers, and other health system stakeholders about how best to deliver and finance care in order to improve the health of the public.

Ortho-McNeil Neurologics

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