ANN ARBOR, Mich. One in eight visits to a a doctor for a headache or migraine end up with the patient going for a brain scan, at a total cost of about $1 billion a year, a new University of Michigan Medical School study finds.
And many of those MRI and CT scans and costs are probably unnecessary, given the very low odds that serious issues lurk in the patients' brains.
In fact, several national guidelines for doctors specifically discourage scanning the brains of patients who complain of headache and migraine. But the new study shows the rate of brain scans for headache has risen, not fallen, since guidelines for doctors came out. This may mean that patient demand for scans drives much of the cost.
The researchers suggest that better education of the public, and insurance plan designs that ask patients to pay part of the cost based on the likely value of the scan for them, may be needed to reduce unnecessary use and spending.
The research, published in JAMA Internal Medicine by a team from the U-M Department of Neurology, uses national data on headache-related doctor visits and neuroimaging scans by people over age 18, and calculates estimated total costs across multiple years.
In all, 51.1 million headache-related patient visits occurred between 2007 and 2010 nearly half of them related to migraine. The vast majority were by people under the age of 65, and more than three-quarters of the patients were women. In those same four years, 12.4 percent of these visits resulted in a brain MRI or CT.
The researchers estimated the total cost of the four years' worth of scans at $3.9 billion, based on typical Medicare payments to doctors for imaging.
"This is a conservative cost estimate based on what Medicare would pay for these tests. CTs and MRIs are commonly ordered for headache and migraine, and increasing over time, despite the fact that there are rare circumstances where imaging should
|Contact: Kara Gavin|
University of Michigan Health System