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Brain disorders cost Europe €800bn a year

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6370 (Published 04 October 2011) Cite this as: BMJ 2011;343:d6370
  1. Ingrid Torjesen
  1. 1London

Europe spends more on brain disorders than on cardiovascular disease and cancer combined, a comprehensive study commissioned by the European Brain Council has found.

The study, published in European Neuropsychopharmacology (doi:10.1016/j.euroneuro.2011.08.008), found that Europe spends €798bn (£685bn; $1060bn) a year on neurological and psychiatric conditions, €192bn on cardiovascular disease, and €150-250bn on cancer. The total costs comprised direct costs, such as treatment, and indirect costs, such as the cost of sickness absence.

The most costly group of brain disorders was mood disorders, including major depression and bipolar disorders (€113bn a year) and dementia (€105bn).

The researchers, who came from across Europe, used existing prevalence and economic data to estimate the costs of 19 groups of brain disorders in 30 European countries in 2010. They found that costs had more than doubled since they undertook a similar estimation of 12 groups of disorders in 28 countries in 2005.

They argue that the costs of brain disorders will continue to rise as people live longer. Brain disorders represent “the number one economic challenge for European healthcare now and in the future,” they say, and far more research is needed into their diagnosis, prevention, and treatment.

The findings show that around a third of Europe’s 514 million people have a brain disorder. Jes Olesen, professor of neurology at the Danish Headache Centre in Copenhagen, said that although some patients may have been counted twice because they had more than one disorder, it was likely that the study actually underestimated the prevalence of brain disorders as a whole and the costs to Europe because it didn’t include hundreds of rare disorders.

Overall Germany spent the most on brain disorders (€122bn) in 2010, followed by the United Kingdom (€110bn), mostly because these are deemed high income countries where costs, particularly for labour, are high.

The analysis took into account direct medical costs (the cost of treatment), direct non-medical costs (such as the cost of nursing homes and social services), and indirect costs (costs of lost labour, sickness pay, and disability pensions). Direct healthcare costs were found to account for 37% of the total, non-medical costs for 23%, and indirect costs for 40%.

Professor Olesen emphasised that although health services may pay only the direct medical costs, all three categories of cost were relevant to society and that efforts were needed to avoid predicted further rises in costs as populations age. This required increased investment in brain science, teaching, and prevention.

Alistair Benbow, executive director of the European Brain Council, said, “Both at European and national level we should make disorders of the brain much higher priority and further strengthen existing programmes, and that will require further funding.

“We need to have more emphasis on research into the causes and developmental pathways of brain disorders, so that we can develop better drugs and better psychological treatments as well as allowing for empirically based treatment.”

He added that there was a real need to understand the underlying brain changes in dementia so that the illness can be diagnosed earlier, when patients are more amenable to treatment.

Dr Benbow said that the amount of time spent looking at brain disorders in medical schools and other medical education was “totally underwhelming and historical” and needed to change to reflect the fact that brain disorders account for around a third of healthcare costs.

Professor Olesen said that the UK, in particular, had “a terrible lack of neurologists.” Denmark and the UK have similar numbers of neurologists, even though the UK population is 10 times that of Denmark.

The researchers intend to publish more specific data on costs of brain disorders in each European country next year.

Notes

Cite this as: BMJ 2011;343:d6370