Absenteeism related wage loss in adults with migraine in the United States using inverse probability of treatment weighting approach

Migraine is a prevalent and debilitating neurological condition, often leading to significant productivity losses. However, the economic impact of absenteeism-related wage loss specifically attributed to migraine remains underexplored. This study aims to estimate the incremental absenteeism-related wage loss among employed adults with migraine. This retrospective cross-sectional study utilized data from the 2019–2021 Medical Expenditure Panel Survey (MEPS). Adults aged ≥ 18 years with a migraine diagnosis, reported employment and had complete data on workdays missed, sick leave, and wages were included. Productivity loss was measured using a human capital approach, calculating absenteeism-related wage loss by multiplying the number of missed workdays by average daily wages. Incremental absenteeism-related wage loss was determined through two-part regression models adjusted with inverse probability of treatment weighting (IPTW). The study included 737,351 employed adults with migraine and 108.53 million adults without migraine. Migraine was more prevalent among women (77.4%), younger adults aged 18–45 years (50.6%), and those with private insurance (77.6%). Compared to non-migraine participants, those with migraine had significantly higher unadjusted absenteeism-related wage loss ($300.32 vs. $203.13 annually). Adjusted analyses revealed that adults with migraine were nearly twice as likely to report missed workdays (adjusted odds ratio [aOR]: 1.89, 95% CI 1.12–2.36) and incurred an additional $836.83 in wage loss annually. Employed adults with migraine experience substantial incremental absenteeism-related wage loss, highlighting the need for targeted workplace interventions and broader policy measures. Addressing this economic burden could mitigate productivity losses and improve quality of life for individuals affected by migraine.