LAUSR

Introduction Prior studies have estimated the burden of migraine in patients suffering from ≥ 4 monthly headache days (MHDs), but the burden experienced by migraineurs suffering from one to three (1–3) MHDs is unknown. The aim of this study was to examine the incremental burden of migraine in terms of health-related quality of life (HRQoL), impairments to work and daily activities, and healthcare resource utilization (HRU) in five European countries (France, Germany, Italy, Spain, and the UK (EU5]), by comparing migraineurs with ≥ 4 MHDs and migraineurs with 1–3 MHDs. Methods The sample for this retrospective cross-sectional study was collected from the 2017 National Health and Wellness Survey ( N  = 62,000). The Short-Form 12-Item Health Survey Instrument, version-2 physical and mental component summary (PCS and MCS) scores, Short-Form 6-dimensions (SF-6D), EuroQoL 5-dimensions (EQ-5D) and EuroQoL visual analog scale (VAS) scores, impairments to work productivity and daily activities (Work Productivity and Activity Impairment [WPAI] Questionnaire) scores, and HRU were compared between migraineur groups with ≥ 4 MHDs (4–7, intermediate-frequency episodic migraine; 8–14, high-frequency episodic migraine; ≥ 15 chronic migraine) and the migraineur subgroup with 1−3 MHDs (low-frequency episodic migraine) using generalized linear modeling after adjusting for covariates. Results Data from a total of 62,000 survey respondents were examined, of whom 1323 and 1569 were considered to have 1–3 MHDs and ≥ 4 MHDs (4–7 MHDs [ n  = 783]; 8–14 MHDs [ n  = 429]; ≥ 15 MHDs [ n  = 357]), respectively. The adjusted HRQoL was significantly lower in the 4–7 MHDs (for MCS and SF-6D scores; p  < 0.0001) and 8–14 MHDs subgroups (for MCS, SF-6D, EQ-5D, and EuroQoL VAS scores, p  < 0.0001; for PCS scores, p  = 0.0007) than in the 1–3 MHDs subgroup. Migraineurs with 4–7 and 8–14 MHDs reported higher activity impairment and more frequent visits to healthcare providers (all p  < 0.0001) and neurologists ( p  = 0.0006 and p  < 0.0001, respectively) compared to the 1–3 MHDs subgroup. Migraineurs with ≥ 15 MHDs had significantly lower HRQoL and increased WPAI scores and HRU than the 1–3 MHDs subgroup. Conclusions This study provides evidence supporting the incremental burden of migraine, characterized by poorer HRQoL and increased WPAI scores and greater HRU, among migraineurs experiencing ≥ 4 MHDs compared with migraineurs experiencing 1–3 MHDs in the EU5.