Costs of disorders of the brain in Europe

In 2004 there were about 46 million cases of neurological diseases such as epilepsy, migraines, multiple sclerosis, Parkinson's disease and stroke among the 466 million inhabitants of the EU (excluding the two new members Romania and Bulgaria, but including the non-members Iceland, Norway and Switzerland).

According to a study entitled “Costs of Disorders of the Brain in Europe” (European Journal of Neurology, Volume 12, Supplement 1, June 2005), a further five million people suffered from dementia, a disease classified both as a neurological and a mental disorder.

Costs of the Various Kinds of Neurological Disorders Neurological diseases incur costs of Euro84 billion a year. Migraines account for about Euro27 billion of the total, strokes for about Euro22 billion, epilepsy for about Euro15.5 billion, Parkinson’s for about Euro10.5 billion and multiple sclerosis for about Euro9 billion. According to the authors of the study, however, these figures are probably much higher, especially for strokes. There was too little precise data available on the frequency and costs of strokes. Dementia, for its part, is associated with financial outlays of Euro55 billion.

Data on neurological care can be found in the Neurology Atlas of the World Health Organization (WHO) for 2004. This survey reference work indicates that Europe has by far the best supply of neurological health care services of the six WHO regions. There are 4.84 neurologists per 100,000 inhabitants in the European countries compared with only 0.03 for Africa. The United States has more than five neurologists per 100,000 inhabitants. For North and South America as a whole, however, the average is only 0.89 neurologist per 100,000 inhabitants.

Cost of Disorders of the Brain and the Nervous System as a Whole If the cost of disorders of the brain and nervous system are viewed as a whole, one has to add to the Euro84 billion figure for neurological disorders and the Euro55 billion for dementia an additional amount of about Euro239.5 billion for mental disorders. Mental disorders include addictions, anxiety disorders, and psychoses as well as affective psychoses such as depression and bipolar disorders. About Euro7.5 billion is spent on neurosurgical disorders such as brain tumors and brain injuries. That adds up to a total of Euro386 billion for 127 million cases for the 466 million inhabitants of the EU 25 plus Iceland, Norway and Switzerland. According to WHO data and the study “Costs of Disorders of the Brain in Europe”, disorders of the brain and the nervous system account for no less than 35 percent of the total health care burden in Europe. Nonetheless, they are not given the same attention as cardio-vascular disease, cancer or AIDS. Since the study was able to deal with only the most common disorders and not all countries covered had sufficient data available, the authors believe the actual cost to the economy is more on the order of Euro500 to Euro700 billion.

Of the estimated Euro386 billion, Euro135 billion are allocable to direct medical costs, which in turn can be broken down into stationary care (Euro78 billion), out-patient care (Euro45 billion) and drug therapy (Euro13 billion). The indirect costs include lost workdays and productivity losses and are estimated at Euro179 billion. The direct non-medical costs include money spent on social services and nursing care and amount to an estimated Euro72 billion.

The per-case costs vary greatly with country and type of disorder. For migraine patients, for example, the per-case costs range from Euro133 in Estonia to Euro1,030 in Switzerland and for patients with brain tumors, from Euro9,375 in Estonia to Euro67,841 in Switzerland.