Brain disorders (mental and neurological disorders) represent 35% of Europe’s total disease burden, and a 2010 study showed that the total cost of this burden amounts to €800bn. The study continued that 40% of this cost is due to indirect costs, such as loss of work productivity, and the direct costs are increased due to lack of diagnosis or misdiagnosis, leading to inadequate treatment. This increases the strain on a country’s national health service. Therefore, it is imperative to maximise the value of treatment by reducing direct costs (higher accuracy of diagnosis) and indirect costs (earlier diagnosis) to ensure therapeutic care remains accessible and sustainable.

The ‘Value of Treatment’ (VoT) project was commissioned by the European Brain Council (EBC) with the objective of identifying treatment gaps and patient needs in the care pathway, evaluating socio-economic costs associated with these gaps and then proposing policy recommendations on how to close these gaps. The project looked at the burden of nine brain disorders in European countries and how to close treatment gaps in these indications.

In a talk at the EAN Congress 2018, the lack of value in one of these indications – restless leg syndrome (RLS) – was highlighted; RLS is one of the most prevalent neurological disorders in Europe, yet also one of the least well studied, which has led to an inefficient diagnosis and treatment algorithm. Patients are often not taken seriously, diagnoses missed, referrals are not done, and false treatments given.

The high prevalence and lack of awareness has meant that RLS has the second highest yearly total cost of neurological disorders in Europe, behind dementia. The VoT concluded that education on RLS was urgently needed to increase awareness with physicians, and research is needed into the etiology of RLS to develop indication-specific drugs. These solutions will improve patient care while simultaneously reducing the burden on national health services, as patients are adequately treated and do not have to keep coming into the hospital with complications.

In a wider context, the conclusions that have come from the VoT project suggests that brain research needs to be placed on the strategic research agenda and to ensure that brain disorder prevention and management are part of policy prioritisation, implementation and evaluation.

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