Migraine, the most debilitating common form of headache, afflicts perhaps 18 million Americans, who collectively lose 64 million workdays a year, and they cost the nation $50 billion in medical expenses and lost work time.
(A) year, and they cost the nation $50 billion in medical expenses and lost
(B) year and thus cost the nation $50 billion in medical expenses and lost
(C) year, so as to cost the nation $50 billion in medical expenses and lost
(D) year that costs the nation $50 billion in lost medical expenses and
(E) year, which thus cost the nation $50 billion in lost medical expenses and

Q/a-b why not d