In this retrospective study, we evaluated the epidemiology of migraine in the southern district of Israel, using the electronic medical records (EMR) database of the largest Israeli Health Maintenance Organization (HMO).

Migraine is a common neurological disease, with an age-standardized prevalence of 14.4% worldwide (GBD 2016 Headache Collaborators. Lancet Neurol. 2018;17:954-976). The introduction of new migraine-specific therapeutic modalities emphasizes the need for epidemiological data on migraine at the national and regional level that will enable decision-makers to identify data-supported policies and resource allocation.

In this population-based retrospective, observational, cohort study, adult migraine patients were identified in the computerized database of the southern district of the "Clalit Health Services" HMO (total population, 0.75 million). Patients were identified based on recorded diagnosis (ICD-9) and/or claims for specific anti-migraine medication (triptans) during 2000-2018. We calculated the prevalence for 2018 per 10,000 adults.

In 2018, a total of 29,938 patients with migraine were identified out of 391,528 adult HMO members. Most of the patients were women (75.8%), and the mean age of diagnosis was 36.94 ± 13.61 years. The overall prevalence of migraine (per 10,000) was 764.64 (7.64%), 1143.34 (11.43%) for women and 374.97 (3.74%) for men. The highest prevalence was observed in patients 50-60 years and 40-50 years (1143.98 and 1019.36, respectively), and the lowest prevalence was among patients 18-30 years and over 70 years (433.45 and 398.49, respectively).

This is the first epidemiological study of migraine prevalence in Israel. Compared to international estimations, migraine appears to be underdiagnosed in Southern Israel.