Evaluating the economic costs of migraine: interest of a comparative approach

The major aim of the paper is to give an epidemiologist's viewpoint on several points related to the evaluation of the costs of migraine and to answer some questions that are important if one wishes to decrease the burden of this disease in the general population. In spite of favourable criteria for the management of migraine, and for epidemiologic and economic studies, the relationship between migraine and cost is not so easy to study. The main reason is that this relation is not determinist, which is a condition for the validity of cost-of-illness studies. Personality of migraineurs, belief in efficacy of the healthcare system, efficacy of the first treatment and attitude of the physician interfere with the relationship between migraine and cost. In our opinion, this fact justifies, in addition to cost-of-illness studies, a comparative approach between migraineurs and non-headache subjects to better appreciate the incremental cost related to migraine