The impact of migraine in New Zealand
Migraine disease is estimated to affect over 753,000 people in Aotearoa New Zealand
The study measures the impact of diseases on death rates and disability, including ‘years of life lived with disability’ (YLD). Migraine is not a fatal disease but it causes significant impairment, so the YLD measure provides a way to quantify the amount and severity of this impairment.
Health and disability impact of migraine
Years of life lived with disability (YLD) calculates the number of years that a person lives with impaired function. It combines an estimate of how common migraine disease is in the population with the average amount of time spent with impaired function (since this varies by person) and a number called a ‘disability weight’. The disability weight is taken from large surveys where participants compare and rate the health status of individuals with differing levels of disease and disability.
In 2021, the Global Burden of Disease study found that migraine caused the fourth-highest amount of YLD worldwide but the second highest cause for adults aged under 50 years. In New Zealand, migraine ranks below low back pain and anxiety and has a similar disability impact to major depressive disorder. The high level of disability is consistent with what we know about the impact of migraine disease on life and functioning.
However, there is a much greater uncertainty about this estimate of disability for migraine than for depression. This can be seen from the width of the black lines on the graph below. Researchers provide these ranges to indicate how sure they are about their results. In the case of migraine, the level of disability could be as high as 1139 YLD per 100,000 (which would be higher than anxiety disorders) or as low as 91 per 100,000 (which would be closer to stroke). We need better research to get more certainty about these results.
Based on Global Burden of Disease 2021 data (http://ghdx.healthdata.org/gbd-results-tool, accessed June 2024)
Social and economic cost of migraine
Migraine disease is most common in people of working age, and three times more common in women than men. Migraine can affect people’s ability to work, study, progress in their careers and engage in social activities and family life.
Although there have been no studies in New Zealand on the economic costs of migraine, a publication from Australia in 2018 found that the yearly cost of chronic migraine per person was AU$21,706; and AU$6,137 for episodic migraine.
This included health system costs, such as paying to see health professionals and for medications, and productivity costs from the reduced ability to work and having to take time off work.
If these estimates are similar for New Zealand, that would equate to around NZ$5 billion a year.
Research into the impact of migraine in New Zealand
In 2022, we undertook a nationwide online survey of people with migraine, resulting in 530 responses. This was the first research into the experience and impact of migraine in Aotearoa New Zealand.
Summary of findings
- Migraine impacted on paid and household work for the majority of respondents, especially those with chronic migraine.
- People reported difficulties in getting effective (and knowledgable) health care for migraine, especially being able to see a neurologist.
- Nearly three quarter of respondents were eligible for preventive treatment, based on frequency and disability from migraine attacks, but only 57% of these were currently taking a preventive.
- There was a clear need for new and more effective medication options, with fewer side effects.
- Just over half were using a migraine-specific acute treatment (a triptan) but risk of overuse of acute treatments was high for people with chronic migraine.
- Most people were using or had previously used supplements but other non-medication approaches were less commonly used.
- It took on average six years from having migraine symptoms to getting a diagnosis. 71% of respondents had a family history of migraine. Many felt judged or misunderstood because of migraine by family and friends, health professionals, partners and workplaces, a sign that migraine stigma is alive and present.
