PND32 Out-of-Pocket Payments and Healthcare Resource Utilization in Patients with Episodic and Chronic Migraine in Moscow, Russia

According to an epidemiological study (Ayzenberg I. et al., 2012), the prevalence of migraine in Russia is over 20%. Generally, diagnostic procedures and hospital treatment of migraine patients are covered by the Mandatory Medical Insurance system, but out-patient medicines are not included into the insurance, and access to medical services is sometimes limited. Meanwhile, little data are available on the out-of-pocket payments of migraineurs in Russia. The aim of the study was the assessment of annual out-of-pocket payments and resource utilization in relation to the migraine severity in patients treated at a neurology clinic in Moscow. Special questionnaire was developed to collect the data on the health care recourses utilization and personal expenditures of migraine patients. 260 migraineurs treated at A.Ya. Kozhevnikov Neurology Clinic (Moscow) in 2019 were selected for the study. Their clinical data were extracted from the medical records database. To find the factors that influence patients’ expenditures and resource utilization, clinical and economical data were analyzed using a regression analysis. Median expenditures spent by a patient with migraine for medical services in 2019 were 16,000 RUB; 25th percentile 5,750 RUB 75th percentile 57,000 RUB (248 USD, 89 USD, and 883 USD respectively). One quarter of the patients did not spend anything for medical care associated with the migraine diagnosis, while other 25% reported as many as 10+ diagnostic procedures (e.g., computer tomography and magnetic resonance imaging) performed in 2019. Female gender, number of migraine attacks during a month and intensity of headache were the main factors associated with higher level of out-of-pocket payments. The study demonstrated relatively high level of out-of-pocket payments on diagnostic procedures and treatment of migraine in Russia and confirmed the correlation between the frequency of migraine attacks and the patients’ expenditures.