To assess trends in direct costs related to inpatient admissions for individuals with migraine as the principal diagnosis in the United States (US) from 2002 to 2015.

Multiple studies have shown that migraine imposes a substantial economic burden in the US. There is a need to investigate the recent trends in inpatient migraine management cost.

Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database, we selected patients with and without a primary diagnosis of migraine upon discharge from US hospitals between 2002 and 2015. “Migraine”, “lumbar puncture (LP)”, “MRI brain” and “CT head” were identified based on ICD codes. Multivariate regression analysis was performed to evaluate the temporal change of admission cost and procedure rate in Stata/SE 15.1 software.

From 2002 to 2015, more patients with migraine are being admitted at a greater cost despite decreased use of diagnostic testing and relatively stable LOS. Further study is warranted to investigate factors driving up the costs. Clinical decision units for migraine patients in the emergency department might provide better quality of care at lower cost to the healthcare system.