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Messali A.,University of Southern California | Sanderson J.C.,VeriTech Corporation | Goadsby P.J.,King's College London | Buse D.C.,University of California at San Francisco | And 8 more authors.
Headache | Year: 2016

Objective The objective of this study was to compare the societal direct and indirect costs of chronic and episodic migraine in the United States. Background Episodic and chronic migraine are distinguished by the frequency of headache-days. Chronic migraine has a greater overall impact on quality of life than does episodic migraine. Individuals with chronic migraine also use more healthcare resources (resulting in higher direct costs) and experience greater decreases in productivity (resulting in higher indirect costs) than those with episodic migraine as shown in the American Migraine Prevalence and Prevention (AMPP) Study. Methods The International Burden of Migraine Study utilized a web-based questionnaire to elicit data on several topics related to the burden of migraine illness, including health resource utilization and productivity losses. Potential survey participants were identified by Synovate Healthcare (Chicago, IL, USA) from a pool of registered panelists from various countries. The panelists were screened online to determine eligibility and to identify individuals with migraine (episodic or chronic), based on reported symptoms. Participants from the United States were divided into episodic and chronic migraine groups, based on reported headache-day per month frequency. Direct and indirect costs were estimated by applying estimated unit costs to reported headache-related productivity losses and resource use. Costs were compared between participants with episodic and chronic migraine. Results Mean [standard deviation] total annual cost of headache among people with chronic migraine ($8243 [$10,646]) was over three times that of episodic migraine ($2649 [$4634], P <.001). Participants with chronic migraine had significantly greater direct medical costs ($4943 [$6382]) and indirect (lost productivity) costs ($3300 [$6907]) than did participants with episodic migraine (direct, $1705 [$3591]; indirect, $943 [$2084]) (P <.001 for each). Unlike previous findings, direct medical costs constituted the majority of total headache-related costs for both chronic migraine (60.0%, $4943 of $8243) and episodic migraine (64.3%, $1705 of $2649) participants. A large portion of direct medical costs are attributable to pharmaceutical utilization among both chronic migraine (80%, $3925 of 4943) and episodic migraine (70%, $1196 of $1705) participants. Conclusion The results of this study build on previous results of the AMPP Study, demonstrating that headache-related direct, indirect, and total costs are significantly greater among individuals with chronic migraine than with episodic migraine in the United States. © 2016 American Headache Society.


PubMed | Health Economics and Epidemiology, Strategy and Research, VeriTech Corporation, University of California at San Francisco and 2 more.
Type: Journal Article | Journal: Headache | Year: 2016

The objective of this study was to compare the societal direct and indirect costs of chronic and episodic migraine in the United States.Episodic and chronic migraine are distinguished by the frequency of headache-days. Chronic migraine has a greater overall impact on quality of life than does episodic migraine. Individuals with chronic migraine also use more healthcare resources (resulting in higher direct costs) and experience greater decreases in productivity (resulting in higher indirect costs) than those with episodic migraine as shown in the American Migraine Prevalence and Prevention (AMPP) Study.The International Burden of Migraine Study utilized a web-based questionnaire to elicit data on several topics related to the burden of migraine illness, including health resource utilization and productivity losses. Potential survey participants were identified by Synovate Healthcare (Chicago, IL, USA) from a pool of registered panelists from various countries. The panelists were screened online to determine eligibility and to identify individuals with migraine (episodic or chronic), based on reported symptoms. Participants from the United States were divided into episodic and chronic migraine groups, based on reported headache-day per month frequency. Direct and indirect costs were estimated by applying estimated unit costs to reported headache-related productivity losses and resource use. Costs were compared between participants with episodic and chronic migraine.Mean [standard deviation] total annual cost of headache among people with chronic migraine ($8243 [$10,646]) was over three times that of episodic migraine ($2649 [$4634], P<.001). Participants with chronic migraine had significantly greater direct medical costs ($4943 [$6382]) and indirect (lost productivity) costs ($3300 [$6907]) than did participants with episodic migraine (direct, $1705 [$3591]; indirect, $943 [$2084]) (P<.001 for each). Unlike previous findings, direct medical costs constituted the majority of total headache-related costs for both chronic migraine (60.0%, $4943 of $8243) and episodic migraine (64.3%, $1705 of $2649) participants. A large portion of direct medical costs are attributable to pharmaceutical utilization among both chronic migraine (80%, $3925 of 4943) and episodic migraine (70%, $1196 of $1705) participants.The results of this study build on previous results of the AMPP Study, demonstrating that headache-related direct, indirect, and total costs are significantly greater among individuals with chronic migraine than with episodic migraine in the United States.


News Article | December 5, 2016
Site: www.prweb.com

Loring Ward today released a special white paper on "Robo-Advisors: Looking Beyond the Low-Cost Service," which compares moderate portfolios built by the top five robo-advisors (Vanguard, Schwab, WealthFront, Betterment and Personal Capital) to a benchmark portfolio with several decades of measurable performance. Based on extensive research by Loring Ward’s Portfolio Strategy and Research Group, the white paper looks at the key characteristics of the robo-advisors’ portfolios, such as asset allocation, diversification, stock and bond risk, investment costs and overall portfolio risk and efficiency. Though the robo-advisor portfolios are generally well diversified, the white paper identifies several gaps in certain other important investment characteristics of these portfolios, including: As Sheldon McFarland, VP with Loring Ward and one of the authors of this white paper, notes, “Robo-advisors might build inexpensive portfolios, but unfortunately they are not delivering anything close to optimal portfolios. This could have a real impact on long-term investors attempting to invest for a critical life goal, such as retirement.” One of the major findings of the white paper is that the robo-advisor’s asset allocations tend to reduce the overall efficiency of their portfolios. This means investors in these portfolios might not be getting the optimum returns possible for their chosen levels of risk and may even be exposed to risks they may not fully understand. According to Loring Ward’s Chief Investment Officer, Payel Farasat, “This whitepaper shares some of the dangers of letting a computer, rather than a human advisor, determine the course of a client’s investing lifetime. This is such an important topic to our industry that we plan to further investigate whether robo-advisors are able to extract in the real world the well-known premiums that arise naturally from known behavioral finance concepts and anomalies.” Click here to view the whitepaper: "Robo-Advisors: Looking Beyond the Low-Cost Service." About Loring Ward Loring Ward (LWI Financial Inc.) is committed to creating a better wealth experience for Financial Advisors and their clients across the U.S. For over 25 years, the firm has strived to do this by empowering Advisors with Investment and Advisor Solutions that increase the probability of delivering a great experience for their clients. We have one of the largest networks of independent Advisors in the United States and are located in Silicon Valley, California. Loring Ward’s Asset Class Investing philosophy is based on almost nine decades of data, analysis and research, insights from behavioral finance, and close relationships with leading academics, including Loring Ward Investment Committee Members Dr. Meir Statman and Nobel Laureate, Dr. Harry Markowitz. As of December 2016, Loring Ward has $13.9 billion in assets under management. For more information, please visit http://www.loringward.com. LWI Financial Inc. (“Loring Ward”) is an investment adviser registered with the Securities and Exchange Commission. Securities transactions are offered through its affiliate, Loring Ward Securities Inc., member FINRA/SIPC. R16-260 (10/18).

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