Treatment Patterns and healthcare costs of Migraine Patients in China: Insights from a Retrospective Database Study

Background Migraine poses a substantial disease and economic burden in China, yet real-world data on treatment patterns and healthcare costs remain limited. Methods We conducted a retrospective cohort study using electronic health records from the Shanghai Municipal Health Statistics Center, including 168,421 patients diagnosed with migraine between 2018 and 2024. Treatment patterns (acute, preventive, and traditional Chinese medicine [TCM]), prescription transitions, and healthcare resource utilization were analyzed descriptively. Results The mean patient age was 56.7 years, and 67% were female. Overall, 74.7% of patients received at least one treatment. Acute medications were used by 37.8% of patients, with NSAIDs being most common. Preventive treatments were prescribed to 28.8%, predominantly flunarizine, while 29.8% received TCM. Triptans were used in only 1.7% of cases, and opioids in 0.53%, including 750 patients prescribed opioids at the first visit without prior standard therapy. Longitudinal prescription analysis revealed a gradual decline in the use of acute and preventive therapies, while TCM use—particularly herbal medicine and acupuncture—increased progressively across successive visits. Outpatient visits averaged 1.57 per patient, with a mean cost of ¥239.95. Costs increased across all institution levels from 2018 to 2023. Hospitalization occurred in 0.48% of patients, with an average stay of 7.4 days and mean inpatient cost of ¥9,892.19. Conclusions This large-scale real-world study reveals underutilization of migraine-specific medications, delayed diagnosis, and a growing shift toward TCM in later stages of care. These findings highlight the need to enhance early diagnosis and optimize adherence to guideline-based treatments, particularly in primary care settings.