LONDON – Funding for headache research and therapy gets the short end of the stick in European neurology.
Two ambitious recent studies tell the tale. One, carried out by the European Brain Council, estimated the annual costs for 19 categories of brain disorders, both neurologic and psychiatric, in 30 European countries. The other study focused specifically on the direct and indirect monetary costs of the major headache disorders, including migraine, tension-type headache, and medication-overuse headache.
Dr. Rigmor Hojland Jensen
Dr. Rigmor Højland Jensen referenced both studies in her address as incoming president of the European Headache Federation at the European Headache and Migraine Trust International Congress.
"Headache is competing with other diseases for funding. These are very important studies we have to include in our arguments all the time," said Dr. Jensen, professor of neurology at the University of Copenhagen.
The European Brain Council study (Eur. J. Neurol. 2012;19:155-62) employed sophisticated modeling techniques to estimate the total cost of brain disorders in Europe in 2010 at 798 billion euros. That’s an average of 1,550 euros per inhabitant.
The average cost per European with a headache disorder in 2010 was 285 euros, a figure that pales in comparison to the 30,000 euros per patient with a neuromuscular disorder. Because headache disorders are so common, though, the total annual cost for headache disorders was calculated at a hefty 43.5 billion euros.
In contrast, the annual total cost for neuromuscular disorders was 7.7 billion euros; for epilepsy, 13.8 billion euros; multiple sclerosis, 14.6 billion euros; Parkinson’s disease, 13.9 billion euros; and traumatic brain injury, 33 billion euros.
"Headaches cost more than epilepsy, multiple sclerosis, and Parkinson’s disease together. And yet how much more research in your department and how many more resources are dedicated to treating these three disorders, compared with headache?" Dr. Jensen asked.
For 2010, the costliest brain disorders in Europe included dementia at 105.2 billion euros, stroke at 64.1 billion euros, and several psychiatric disorders: psychotic disorders came in at 93.9 billion euros, mood disorders at 113.4 billion euros, anxiety disorders at 74.4 billion euros, and addiction disorders at 65.7 billion euros. In addition, the cost of personality disorders was estimated at 27.3 billion euros and somatoform disorders at 21.2 billion euros.
The headache cost study, known as the Eurolight Project, involved extrapolation from a detailed cross-sectional survey conducted in 8,412 individuals in eight countries representing 55% of the adult European Union population.
The investigators calculated the annual cost of headache among 18- to 65-year-olds in the European Union at 173 billion euros. That’s considerably more than the 43.5 billion euros figure cited in the European Brain Council study because, in figuring the estimated indirect costs associated with headache, the Eurolight Project investigators included not only work absenteeism but also reduced productivity while at work.
Sixty-four percent of the estimated annual cost of headache among European adults was apportioned to migraine, 21% to medication-overuse headache, 12% to tension-type headache, and the remainder to other headaches (Eur. J. Neurol. 2012;19:703-11).
Dr. Jensen reported financial relationships with ATI, Medotech, Merck, Neurocore, NorPharma, and Pfizer.