Experts from the University of Cambridge, University of Hertfordshire and Imperial College London believe that disorders of the brain pose the greatest economic challenge for UK health care. The research is the most recent and comprehensive study conducted on the costs and prevalence of brain disorders in the UK.
Every year disorders of the brain, including dementia, stroke, and mental health issues, cost the UK an estimated £112 billion* (€134 billion), according to a new report out today by leading neuroscientists. The figure, which includes direct medical costs as well as indirect costs (i.e. lost production due to work absence or early retirement), is more than the GDP of New Zealand.
Professor Barbara Sahakian, one of the lead researchers from the University of Cambridge and President of the British Association for Psychopharmacology, said: “Given the ageing population, the prevalence and cost of UK brain disorders is likely to continue to increase, adding additional pressure on the NHS and Social Services, particularly in regard to the cost of institutionalised care.”
The study reveals that in 2010, the year for which the most recent data is available, there were approximately 45 million diagnoses of brain disorders in the UK, including 8,196,000 (18.17% of UK population) cases of anxiety disorder and 5,268,000 (11.68%) cases of sleep disorder and greater than one million cases of addiction (1,878,000 (4.16%)), mood disorder (i.e. unipolar depression and bipolar disorders) (3,937,000 (8.73%)) and somatoform disorder (2,396,000 (5.31%)), illness that cannot be attributed to a physical problem. Additionally, there were 26,000 cases of brain tumour and 18 million cases of headache requiring medical attention.
The researchers estimated that the total UK cost of disorders of the brain in 2010 was £112,825* million (€134,476 million). Because of limitations in data for some disorders, which was therefore not included, the scientists consider their total estimate of the cost to be conservative.
Annually, the cost of the five most expensive disorders were: dementia: €22,164 million (£18,595 million*); psychotic disorders: €16,717 million (£14,025 million*); mood disorders: €19,238 million (£16,140 million*); addiction: €11,719 million (£9,832 million*) and anxiety disorders: €11,687 million (£9,805 million*). Indirect costs associated with patients' productivity losses constituted by far the largest component of the total cost at €62,346 million (£52,308*), comprising 46.4% of the overall cost, whereas the remainder of the cost was divided into 26.8% each for direct non-medical (€36,077 million (£30,268*)) and direct health-care (€36,053 million (£30,248*)).
The cost of dementia on the social care system was significantly higher than that for cancer, coronary heart disease (CHD) and stroke. Combining the annual costs of health and social care, dementia cost £10.5 billion, compared to £4.5 billion for cancer, £2.7 billion for stroke and £2.3 billion for CHD. After combining health and social care, informal care and productivity losses, dementia also had the highest annual cost at £23 billion, followed by cancer (£12 billion), CHD (£8 billion) and stroke (£5 billion).
However, despite UK government recommendations saying health research priorities should be informed by the impact of disease on the population and economy, the majority of health research funding in the UK has historically been directed towards cancer (£590 million) while research spending on brain disorders, such as dementia (£50 million) and stroke (£23 million), has been comparatively seriously underfunded. As such, the neuroscientists and clinicians who led the study are advocating for a transformation of how funding is allocated, with the focus on distributing funding according to diseases’ economic burden.
Professor David Nutt, a lead author of the report and Edmond J Safra chair in Neuropsychopharmacology at Imperial College London, said: “Clinical and economic challenges posed by brain disorders requires coordinated effort at an EU and national level to transform the current scientific, healthcare and educational agenda. Diseases need to be ranked according to their economic burden to help more efficiently allocate current and future research funds.”
The researchers argue that brain disorders involve disproportionally high indirect costs (i.e. lost production due to work absence or early retirement) and relatively low direct health and social care costs. This means that the application of more effective treatment has the potential to considerably reduce the overall economic burden to society and improve patient quality of life, over and above any reductions in healthcare costs. They believe this is a clear argument for investing in research that leads to a better understanding of how to most effectively prevent, diagnose, treat and manage brain diseases.
Professor Sahakian, added: “No group of chronic diseases costs the world more than brain disorders, with one third of the adult population suffering from a mental disorder every year. However, although brain disorders affect more people than cancer and cardiovascular disease, they receive significantly less in research funding.”
The scientists also highlight an impending crisis in drug development. Major pharmaceutical companies have withdrawn from key areas of preclinical and clinical neuroscience research.
Professor Naomi Fineberg, a lead author of the report from the University of Hertfordshire and Hertfordshire Partnership University NHS Foundation Trust stated: “It is very important that there is novel drug development as a key component of research in order to find effective treatments for all patients thereby allowing them to have a better quality of life and to return to their normal activities at work and at home.”
The findings were published in the Journal of Psychopharmacology. The work was supported by the British Association for Psychopharmacology, European College of Neuropsychopharmacology, the European Brain Council and the Wellcome Trust.