SINGAPORE — Migraines cost Singapore an estimated $1.04 billion last year, in terms of healthcare costs and productivity losses incurred by working adults in the Republic, an inaugural study on the condition has found.
Findings from a joint survey by the Duke-National University of Singapore (NUS) and pharmaceutical company Novartis, released on Wednesday (18 September), revealed that 80 per cent of the total estimated cost was due to a loss of productivity, resulting from missed work days or impacts on employees’ capacity to carry out their daily jobs.
The remaining 20 per cent - about $0.2 billion - comprises healthcare expenses, such as medical tests, alternative medicine, consultation, hospitalisation and medications.
Over 600 Singapore-based migraine patients, with an average age of 38 years old, participated in the online survey between June and September last year. Around 55 per cent of the respondents hold managerial positions, while the remaining 45 per cent included those who are self-employed and semi-skilled workers.
Two groups were identified during the research: those with “lower end episodic migraine” who have three or less daily migraine attacks per month, and those with “upper end episodic migraine” who have four to 14 daily migraine attacks per month.
The study showed that the per capita costs incurred last year for the two groups were $5,040 and $14,860, respectively.
Respondents were found to have missed work 9.8 days a year, on average, due to migraine, while those present at work had their ability to perform tasks reduced due to the symptoms of the condition, resulting in productivity losses of around 7.4 days a year.
As a result, patients can be negatively affected in their prime earning years and suffer from long-term career implications, said Dr Eric Finkelstein, professor at the Health Services and Systems Research Programme at Duke-NUS Medical School and co-author of the study.
Much of their incurred medical costs are also wasted on non-effective treatments, such as tests and diagnostics, he added.
Comparatively, the estimated medical expenditure per patient in Singapore is about nine times higher than those from European countries, but around half of that reported in the US.
But Dr Jonathan Ong, president of Headache Society of Singapore and the study’s co-author, stressed that the estimated $1.04 billion loss was “just a tip of the iceberg”.
“We have discounted chronic migraine patients...and those who are not working where their headaches have taken them away from the workforce. This is something we need to study to get a more accurate estimate,” said the National University Hospital neurology consultant.
More than 300,000 affected
Migraine ranks as the second most burdensome disease worldwide in terms of years lived with the disability, according to a 2016 Global Burden of Disability study.
It is a recurrent neurological disorder marked by unilateral headaches of moderate to severe intensity that typically last between four and 72 hours. It is often accompanied by varying symptoms, such as nausea, sensitivity to light and sound.
It is also thrice as common among females compared to males, with the majority of sufferers experiencing their first attack before the age of 40.
Dr Ong noted that 10 per cent of the population - or 330,00 people - are currently affected by the condition, with about 100 additional patients seen every month at the NUH’s patient referral clinic for headache disorders.
Cases have also gone up by 8.7 per cent from 2005 to 2016 in Singapore, Dr Ong noted, adding that the increase is unsurprising given the increasingly stressful work environment in Singapore.
He hoped the findings would help ease the stigma of the “invisible” yet chronic disease, and also pave the way for migraine-friendly policies and workplace practices.
These include appropriate government-led incentives for employers to provide flexible working systems to employ and retain staff with such fluctuating and episodic conditions.
Implementing simple workplace rules, such as allowing migraine suffers to wear sunglasses or anti-glare glasses and noise-cancelling headphones in the office, can “go a long way”, added Dr Ong.