Costs of Disorders of the Brain in Europe
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EUROPEAN JOURNAL OF NEUROLOGY Volume 12, Supplement 1, June 2005 Costs of Disorders of the Brain in Europe Guest Editors: Patrik Andlin-Sobocki1, Bengt Jönsson2, Hans-Ulrich Wittchen3 and Jes Olesen4 1 Stockholm Health Economics, Stockholm, Sweden and Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden 2 Center for Health Economics, Stockholm School of Economics, Stockholm, Sweden 3 Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany 4 Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark Peer review panel: Laszlo Gulacsi Martin Knapp Massimo Moscarelli 1471-0552(200506)12:06+1;1-4 European Journal of Neurology Volume 12, Supplement 1, June 2005 Costs of Disorders of the Brain in Europe Contents iii LIST OF CONTRIBUTORS vi PREFACE AND ACKNOWLEDGEMENTS viii EDITORS FOREWORD x EXECUTIVE SUMMARY 1 PART I. COST OF DISORDERS OF THE BRAIN IN EUROPE 1 Introduction 1 Materials and methods 1 Economic data 3 Epidemiology data 3 Cost-of-illness methodology 5 Scope of study 6 Health economic model 7 Results 7 Total prevalence 9 Cost per patient 9 Total cost of brain disorders 9 Cost of brain disorders per inhabitant 11 Cost of brain disorders distributed by resource items 13 Cost of brain disorders distributed by medical speciality and specific brain disorder 13 Results on specific dimensions in brain disorders in Europe 18 Sensitivity analysis and validation of results 20 Discussion 20 Final results and uncertainty 21 Methodological aspects 21 Missing data 22 Comparison with cost and burden of other diseases 22 Collaboration between epidemiologists and economists 23 Implications for European research policy 23 Implications for European health care policy 23 Implications for medical school and other health educational curricula 24 Conclusions and recommendations 24 References PART II. EPIDEMIOLOGIC AND ECONOMIC EVIDENCE IN SPECIFIC BRAIN DISORDERS IN EUROPE 28 Cost of addiction in Europe Patrik Andlin-Sobocki and Jürgen Rehm 34 Cost of affective disorders in Europe Patrik Andlin-Sobocki and Hans-Ulrich Wittchen 39 Cost of anxiety disorders in Europe Patrik Andlin-Sobocki and Hans-Ulrich Wittchen 45 Cost of brain tumour in Europe Mattias Ekman and Manfred Westphal 50 Cost of dementia in Europe Linus Jönsson and Claudine Berr 54 Cost of epilepsy in Europe Lars Forsgren, Ettore Beghi and Mattias Ekman 59 Cost of migraine and other headaches in Europe Jenny Berg and Lars Jacob Stovner 63 Cost of multiple sclerosis in Europe Gisela Kobelt and Maura Pugliatti 68 Cost of Parkinson's disease in Europe Peter Lindgren, Sonja von Campenhausen, Annike Spottke, Uwe Siebert and Rickard Dodel 74 Cost of psychotic disorders in Europe Patrik Andlin-Sobocki and Wulf Rössler 78 Cost of stroke in Europe Thomas Truelsen, Mattias Ekman and Gudrun Boysen 85 Cost of trauma in Europe Jenny Berg, Fernanda Tagliaferri and Franco Servadei European Journal of Neurology 2005, 12 (Suppl. 1): iii–v List of contributors Steering committee (alphabetic order): Patrik Andlin-Sobocki, Stockholm Health Economics, Germany; Eva Dragomirecka, Prague Psychiatric Cen- Stockholm, Sweden and Department of Learning, In- ter, Prague, Czech Republic; Jelena Drulovic, Institute formatics, Management and Ethics, Karolinska Insti- of Neurology, Clinical Centre of Serbia, Belgrade, tutet, Stockholm, Sweden; Bengt Jo¨nsson, Center for Serbia; Carlo Faravelli, Department of Neurology and Health Economics, Stockholm School of Economics, Psychiatry, University of Florence, Florence, Italy; Stockholm, Sweden; Jes Olesen, Department of Neur- Lydia Fehm, Clinical Psychology and Psychotherapy, ology, Glostrup University Hospital, Glostrup, Den- Technische Universita¨t Dresden, Dresden, Germany; mark; Hans-Ulrich Wittchen, Max-Planck-Institute of Lars Forsgren, Department of Neurology, Umea˚Uni- Psychiatry, Munich, Germany and Clinical Psychology versity Hospital, Umea˚, Sweden; Tom Fryers, Depart- and Psychotherapy, Technische Universita¨t Dresden, ment of Psychiatry, University of Leicester, Leicester, Dresden, Germany. UK; Tomas Furmark, Department of Psychology, Uppsala University, Uppsala, Sweden; Ron de Graaf, Trimbos-Instituut, Utrecht, Netherlands; Knut Hagen, Epidemiologists (alphabetic order): Norwegian National Headache Centre, St. Olavs Uni- Christer Allgulander, Karolinska Institutet, Stockholm, versity Hospital, Trondheim, Norway; Erkki Isometsa¨, Sweden; Jordi Alonso, Institut Municipal d’Investigacio´ Department for Mental Health and Alcohol Research, Me` dica, Barcelona, Spain; Carlo Altamura, Depart- Helsinki, Finland; Frank Jacobi, Clinical Psychology ment of Psychiatry, University of Milan, Milan, Italy; and Psychotherapy, Technische Universita¨t Dresden, Jules Angst, Department of Psychiatry, University of Dresden, Germany; Heinz Katschnig, Medical Univer- Zurich, Zurich, Switzerland; Eni Becker, Department of sity of Vienna, Department of Psychiatry, Vienna, Clinical Psychology, Faculty of Social Science, Rad- Austria; Marjan Korsic, University Department of boud University Nijmegen, Nijmegen, Netherlands; Neurosurgery, Lubjana University Hospital, Lubjana, Ettore Beghi, Istituto ÔÔMario NegriÕÕ, Milan, Italy; Ju- Slovenia; Ludwig Kraus, Institute for Therapy Re- lien Bogousslavsky, Department of Neurology CHUV, search, Munich, Germany; Jess F Kraus, WHO Neu- Lausanne, Switzerland; Ruth Bonita, World Health rotrauma Collaborating Centre, Department of Injury Organization, Geneva, Switzerland; Bernhard Born- Prevention, UCLA, Los Angeles, USA; Jean-Pierre schein, Department of Neurology; Friedrich-Wilhelms- Le` pine, Hoˆpital Fernand Widal, Paris, France; Rose- University Bonn, Bonn, Germany; Claudine Berr, IN- lind Lieb, Max-Planck-Institute of Psychiatry, Unit SERM E0361, Pathologies du syste` me nerveux: Clinical Psychology and Epidemiology, Munich, Ger- recherche e´pide´miologique et clinique, Hoˆpital La Co- many; Jouko Lo¨nnqvist, Department for Mental Health lombie` re, Montpellier, France; Gudrun Boysen, and Alcohol Research, Helsinki, Finland; Colin Ma- Department of Neurology, Bispebjerg Hospital, Uni- thers, World Health Organization, Geneva, Switzer- versity of Copenhagen, Copenhagen, Denmark; Wim land; Julien Mendlewicz, Hospital Erasme ULB, van den Brink, Department of Psychiatry, Academic Department of Psychiatry, Brussels, Belgium; Ivan Medical Center, Amsterdam Institute of Addiction Milanov, University Neurological Hospital ÔSt. NaumÕ Research, Amsterdam, Netherlands; Traolach Brugha, and Department of Neurology, District Hospital, Sofia, Department of Psychiatry, University of Leicester, UK; Bulgaria; Povl Munk-Jo¨rgensen, Department of Psy- S. Campenhausen, Department of Neurology; Fried- chiatric Demography, Institute for Basic Psychiatric rich-Wilhelms-University Bonn, Bonn, Germany and Research, Aarhus, Denmark; Wolfgang H Oertel, Department of Neurology, Ludwig-Maximilians Uni- Department of Neurology, University Marburg, Mar- versita¨t, Munich, Germany; Herwig Carton, Depart- burg, Germany; Jes Olesen, Department of Neurology, ment of Neurology, Universitaire Ziekenhuizen, Glostrup University Hospital, Glostrup, Denmark; Jim Leuven, Belgium; Giovanni B. Cassano, Department of van Os, Department of Psychiatry and Neuropsychol- Psychiatry, Neurobiology, Pharmacology and Biotech- ogy, Maastricht University, Mastricht, Netherlands; nology, University of Pisa, Pisa, Italy; Christian Com- Andre Oun, Department of Neurology and Neurosur- pagnone, WHO Neurotrauma Collaborating Centre, gery, University of Tartu, Tartu, Estonia; Daniel Pag- M.Bufalini Hospital, Cesena, Italy; Fiammetta Cosci, nin, Department of Psychiatry, Neurobiology, Department of Neurology and Psychiatry, University of Pharmacology and Biotechnology, University of Pisa, Florence, Florence, Italy; Richard Dodel, Department Pisa, Italy; Julio Pascual, Neurology Service, University of Neurology, Friedrich-Wilhelms-University, Bonn, Hospital Marques de Valdecilla, Santander, Spain; Ó 2005 EFNS iii iv Eugene S. Paykel, University of Cambridge, Cam- Thomas Truelsen, The Danish Epidemiology Science bridge, UK; Antoine Pelissolo, Hospital Pitie´-Sal- Center at the Institute of Preventive Medicine, Copen- pe´trie` re, Paris, France; Lukas Pezawas, National hagen University Hospital, Copenhagen, Denmark; Institute of Mental Health (NIMH), Bethesda, USA; Elisabetta Truglia, Department of Neurology and Psy- Bartlomiej Piechowski-Jo´zwiak. Department of Neur- chiatry, University of Florence, Florence, Italy; ology CHUV, Lausanne, Switzerland and Department Johannes Wancata, Medical University of Vienna, of Neurology, Medical University of Warsaw, Warsaw, Department of Psychiatry, Vienna, Austria; La´szlo´ Poland; Bozena Pietrzykowska, Institute of Psychiatry Vecsei, Department of Neurology and MTA-SZTE and Neurology, Warzaw, Poland; Stefano Pini, Neurology Research Group, University of Szeged, Department of Psychiatry, Neurobiology, Pharmacol- Szeged, Hungary; Manfred Westphal, Department of ogy and Biotechnology, University of Pisa, Pisa, Italy; Neurosurgery, University of Hamburg, Hamburg, Werner Poewe, Department of Neurology, Innsbruck Germany; Regina Wick, Department of Neurology, University, Innsbruck, Austria; Maura Pugliatti, Insti- Philipps-University Marburg, Marburg, Germany; tute of Clinical Neurology, University of Sassari, Sas- Hans-Ulrich Wittchen, Max-Planck-Institute of Psy- sari, Italy; Vale´ria de Queiroz, Department of chiatry, Munich, Germany and