PND49 OUT-OF-POCKET EXPENSES IN MIGRAINE IN PORTUGAL

Abstract

Migraine is a disabling disease with a considerable impact on daily activities. Current standard of care has limitations regarding its efficacy and a poor tolerability profile. This may end in patients looking for alternative therapies, which in turn result in out-of-pocket expenses. We aimed to characterize the out-of-pocket expenses incurred by patients with migraine in Portugal. A worldwide, cross-sectional, online survey was conducted including migraine patients recruited via online panels and patient organizations from September 2017-February 2018. Study participants were adults reporting 4 or more monthly migraine days over the 3 months previous to survey with a pre-determined quota of 90% participants having received previous preventive migraine treatment. Out-of-pocket expenses were self-reported by the participants. Results from the Portuguese sample are reported. A total of Portuguese 143 participants were included, 80% female, mean age 37.3 years (range: 18-72 years), 56% have children, 73% are employed, and 60% have an household income ≤€1,500/month. About 82% of the participants reported out-of-pocket expenses: 66% related with drug prescription fees, 52% with over-the-counter medication, 40% with medical appointment fees, 31% with transportation to medical appointments, 23% with emergency room visits, 20% with health insurance, 16% with complementary treatment, and 9% with other. Overall, out-of-pocket expense averaged €102/participant/month (range: €0-€970). Cost drivers were drug prescription fees (30% of the overall average expense) followed by medical appointment fees (15%). Participants who failed two or more prophylactic treatments reported an out-of-pocket expense mean of 141 €/participant/month like participants who failed three or more. These results are important to understand the out-of-pocket burden of migraine in Portugal and may be of support to justify new interventions capable of reducing this burden.