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      Cost of Disorders of the Brain in Spain

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          Abstract

          Background

          Brain disorders represent a high burden in Europe and worldwide. The objective of this study was to provide specific estimates of the economic costs of brain disorders in Spain, based on published epidemiological and economic evidence.

          Methods

          A cost-of-illness study with a societal perspective of 19 brain disorders was carried out. Cost data published between 2004 and 2012 was obtained from a systematic literature review. Direct healthcare, direct non-medical and indirect costs were considered, prioritizing bottom-up information. All costs were converted to Euro and to year 2010. The missing values were imputed with European estimates. Sensitivity analyses based on qualitative assessment of the literature and on a Monte Carlo simulation were performed.

          Results

          The review identified 33 articles with information on costs for 11 disorders (8 neurological, 3 mental). The average per–patient cost ranged from 36,946 € for multiple sclerosis to 402 € for headache. The societal cost of the 19 brain disorders in Spain in 2010 was estimated in 84 € billion. Societal costs ranged from 15 € billion for dementia to 65 € million for eating disorders. Mental disorders societal cost were 46 € billions (55% of the total), while neurological disorder added up to 38 € billion. Healthcare costs represented 37% of the societal costs of brain disorders, whereas direct non-medical constituted 29% and indirect costs 33%.

          Conclusion

          Brain disorders have a substantial economic impact in Spain (equivalent to almost 8% of the country's GDP). Economic data on several important brain disorders, specially mental disorders, is still sparse.

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          Most cited references37

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          The cost of headache disorders in Europe: the Eurolight project.

          Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe.   From November 2008 to August 2009, a cross-sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom-up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs.   Mean per-person annual costs were €1222 for migraine (95% CI 1055-1389; indirect costs 93%), €303 for tension-type headache (TTH, 95% CI 230-376; indirect costs 92%), €3561 for medication-overuse headache (MOH, 95% CI 2487-4635; indirect costs 92%), and €253 for other headaches (95% CI 99-407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually).   Headache disorders are prominent health-related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.
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            Cost of disorders of the brain in Europe.

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              Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS)

              Migraine is a disabling neurological disease that affects 14.7 % of Europeans. Studies evaluating the economic impact of migraine are complex to conduct adequately and with time become outdated as healthcare systems evolve. This study sought to quantify and compare direct medical costs of chronic migraine (CM) and episodic migraine (EM) in five European countries. Cross-sectional data collected via a web-based survey were screened for migraine and classified as CM (≥15 headache days/month) or EM (<15 headache days/month), and included sociodemographics, resource use data and medication use. Unit cost data, gathered using publicly available sources, were analyzed for each type of service, stratified by migraine status. Univariate and multivariate log-normal regression models were used to examine the relationship between various factors and their impact on total healthcare costs. This economic analysis included data from respondents with migraine in the UK, France, Germany, Italy, and Spain. CM participants had higher level of disability and more prevalent psychiatric disorders compared to EM. CM participants had more provider visits, emergency department/hospital visits, and diagnostic tests; the medical costs were three times higher for CM than EM. Per patient annual costs were highest in the UK and Spain and lower in France and Germany. CM was associated with higher medical resource use and total costs compared to EM in all study countries, suggesting that treatments that reduce headache frequency could decrease the clinical and economic burden of migraine in Europe. Comparing patterns of care and outcomes among countries may facilitate the development of more cost-effective care, and bring greater recognition to patients affected by migraine.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                18 August 2014
                : 9
                : 8
                : e105471
                Affiliations
                [1 ]IMIM - Health Services Research Group, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
                [2 ]CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
                [3 ]Pompeu Fabra University, Barcelona, Spain
                [4 ]Quantify Research, Stockholm, Sweden
                [5 ]Karolinska Institutet Alzheimer's Disease Research Center, Stockholm, Sweden
                [6 ]Center for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
                Hospital Nacional de Parapléjicos, Spain
                Author notes

                Competing Interests: The authors declare the affiliation of Anders Gustavsson to be Quantify Research, Stockholm. This does not alter their adherence to all PLOS ONE policies on sharing data and materials. There are no restrictions on sharing data or materials.

                Conceived and designed the experiments: OPB GB JA AG LSC. Performed the experiments: OPB GB JA. Analyzed the data: OPB PJ GB JA. Contributed reagents/materials/analysis tools: OPB GB PJ JA LSC AG. Contributed to the writing of the manuscript: OPB GB PJ JA LSC AG.

                Article
                PONE-D-14-12816
                10.1371/journal.pone.0105471
                4136914
                25133395
                c3e8e5d9-1bf6-4a6b-9633-1f56be5ede86
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 March 2014
                : 24 July 2014
                Page count
                Pages: 10
                Funding
                The author(s) received no specific funding for this work. Co-author Anders Gustavsson is employed by Quantify Research, Stockholm. Quantify Research, Stockholm provided support in the form of salary for author AG, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘author contributions’ section.
                Categories
                Research Article
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Headaches
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Neuropsychiatric Disorders
                Anxiety Disorders
                Dementia
                Eating Disorders
                Neurology
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Epilepsy
                Vascular Medicine
                Stroke
                Physical sciences
                Mathematics
                Statistics (mathematics)
                Statistical methods
                Monte Carlo method
                Social Sciences
                Economics
                Finance
                Financial Management
                Indirect Costs
                Economic Models
                Cost Models
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Custom metadata
                The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are available within the paper.

                Uncategorized
                Uncategorized

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