Project Background
Akros is supporting a national migraine education and advocacy initiative exploring research to quantify the economic burden of migraine in the United States and strengthen the case for earlier identification and more appropriate care.
The analysis may need to account for diagnosed, undiagnosed, and underdiagnosed migraine; avoidable emergency department utilization; diagnostic testing and imaging; fragmented or ineffective treatment pathways; consumer spending; and indirect costs such as absenteeism and presenteeism.
The client has not yet selected a final research design. Two potential pathways are under consideration: a broad national economic burden study to support advocacy and policy conversations, or a more focused business case evaluating the cost and potential value of defined changes in the clinical pathway.
Consultant will serve as Akros’ actuarial, medical economics, or health economics subject-matter expert to help refine the methodology, establish a defensible scope, and potentially lead the resulting analysis.
Key Questions
The engagement will answer the following questions:
What research design would best support the intended audience and desired action, including payer or employer adoption, advocacy, funding, public awareness, or policy change?
Can a credible national estimate of migraine burden be developed using published literature and public data, and what additional value would proprietary claims data provide?
How should diagnosed, undiagnosed, and underdiagnosed migraine populations be defined and segmented?
How should direct medical costs, patient out-of-pocket costs, employer productivity losses, and quality-of-life burden be estimated without double counting or overstating precision?
How should costs be allocated across commercial insurers, Medicare, Medicaid, self-funded employers, consumers, and other stakeholders?
How should delayed or missed diagnosis be evaluated, including emergency care, imaging, specialist visits, medications, unnecessary testing, and ineffective treatment?
Would a national economic burden study or an intervention-specific business case provide the most useful and credible first deliverable?
What clinical expertise, datasets, claims analysis, peer review, sensitivity testing, and publication support would be required?
Scope of Work
Consultant will begin with a bounded research-design phase and work with Akros and designated clinical stakeholders to clarify the intended audience, target population, priority economic outcomes, available data, publication expectations, and practical limits on time and budget.
Consultant will compare two potential research pathways and recommend which should be pursued first:
National Economic Burden Study: Estimate the national burden of migraine to inform advocacy, public education, funding, or policy discussions. The approach may include literature synthesis, public-data analysis, economic modeling, stakeholder allocation, sensitivity testing, and claims analysis if authorized.
Intervention-Specific Business Case: Estimate the cost and potential value of adopting a defined clinical intervention or pathway change. The approach may include current-state pathway mapping, intervention definition, utilization and cost assumptions, comparative modeling, and sensitivity testing.
The recommendation will distinguish what can be measured directly from what must be modeled and identify major sources of uncertainty and the expected credibility and usefulness of the resulting findings.
If the intervention-specific pathway is selected, Consultant will help identify a small number of actionable changes in the migraine care pathway and recommend which should be modeled first. Potential interventions may include screening tools, diagnostic protocols, referral pathways, education programs, or other defined process changes.
Deliverable
Consultant will prepare a concise Research Design and Feasibility Memorandum that includes:
A recommended primary research pathway and rationale
Defined study population, perspective, time horizon, economic outcomes, and stakeholder segments
A conceptual model of the migraine patient journey, major cost categories, and points of attribution
A data-source inventory covering public datasets, published research, and recommended claims or proprietary data
A methodology distinguishing observed evidence from modeled assumptions
Recommended sensitivity or scenario analyses
A clinical-input plan identifying where migraine expertise is required
A proposed analytical workplan, project team, schedule, budget, and publication or peer-review options
Key risks, limitations, unresolved questions, and decisions required before proceeding
If Akros and the client authorize a full study, the final analytical scope will be established separately. Potential outputs may include an actuarial or medical economic model, technical methods documentation, an executive summary, payer- or employer-facing findings, and a publication-ready white paper.
Meetings and Collaboration
The engagement includes:
One kickoff meeting with Akros
One research-design discussion with designated client and clinical stakeholders
Reasonable written follow-up questions during the assessment
One draft review with Akros
One findings and recommendation discussion, which may include the client
Reasonable revisions necessary to finalize the memorandum
Akros will manage all client communications unless the Consultant is expressly invited to participate.
Timeline
Consultant will provide the earliest feasible start date and proposed turnaround for the initial research-design phase.
Akros anticipates approximately two to four weeks after kickoff and receipt of required materials for completion of the Research Design and Feasibility Memorandum.
Consultant will also provide an indicative timeline for a full literature- and public-data-based study and explain how claims analysis, data acquisition, clinical review, independent review, or publication requirements could affect the timeline.
Consultant Responsibilities
Consultant will personally perform or directly supervise the work and identify all proposed contributors in advance.
Consultant will maintain strict confidentiality, use current and traceable sources, disclose conflicts of interest, document material assumptions, and communicate uncertainty or limitations that could materially affect the findings.
Consultant may not identify or contact the client, migraine advocacy organization, payers, employers, providers, researchers, data vendors, or other outside parties regarding the project without Akros’ prior written authorization. Project information may not be shared, reused, published, or referenced in marketing materials without Akros’ written approval.
Exclusions
Unless separately authorized, the initial engagement does not include purchasing or licensing claims data; conducting original claims analysis; interviewing payers, employers, clinicians, or patients; institutional review board submissions; primary clinical research; legal or regulatory advice; peer-review submission; journal publication fees; lobbying; or implementation of any recommended intervention.
Fees
Consultant will complete the initial engagement for the fees and payment terms stated in the applicable work order or contractor agreement. Work beyond the approved scope requires Akros’ prior written approval.
Acceptance
The engagement will be considered complete when the final Research Design and Feasibility Memorandum has been delivered, material recommendations are supported by traceable sources or clearly identified professional judgment, and reasonable comments from Akros have been addressed.
Project Published
October 5, 2026