There is a need for a national, holistic brain health program, which can help to turn the peaking curve of brain disease costs downward.
Brain diseases affect — directly or indirectly — nearly all Finns. Overall, 30 % of men and 50 % of women above 45 years of age are likely to contract a severe brain disease. Over 25 % of those falling ill with a brain disease are of working age.
“The number of cerebrovascular disorders has stabilized to a certain level, but given the aging population, the number of brain diseases is on the increase, and so are the total costs,” says Risto O. Roine, Professor of Neurology at the University of Turku, and the Chair of the Board at the Finnish Brain Council.
“We know, for instance, that 40 % of cases of Alzheimer’s disease could be prevented with lifestyle changes: type two diabetes mellitus, high blood pressure, smoking, excess weight, lack of physical exercise, and hearing impairments are known risk factors for developing Alzheimer’s disease.”
Finnish Brain Council strongly promotes developing a national brain health program. Roine considers both Finnish Brain Council and Neurocenter Finland, alongside the Finnish Institute for Health and Welfare and the Ministry for Social and Health Affairs, as natural partners for implementing the program.
“It is important to implement the brain health program in a professional way and with enough resources at hand. Finnish Brain Council has been promoting this initiative in many ways for several years now.”
Determining the costs of brain diseases
Before the implementation of the program, the total costs of brain diseases must be compiled, says Roine. Once the facts have been compiled and determined, it is possible to identify the most cost-efficient therapies and calculate the savings that are to be expected with efficient interventions.
“At the moment, the data related to the costs of brain diseases is fragmented and outdated.”
According to Roine, compiling the overall costs of brain diseases is not a huge or difficult assignment; it just needs to be done. The costs can be accessed via various registries that contain relevant data about the frequency of diseases as well as therapies and their costs. Registries currently available for mining data include the Kela Medical Products Database, Health Care Notification Registry (Hilmo), and the registry for out-patient health care.
The major challenge, as Roine puts it, is the lack of systematic qualified data collection about the impact of treatments and therapies, which would ideally be the foundation for understanding the cost effectiveness of interventions. Collecting and reporting data should become a standard procedure in the health care sector.
“Registering mortality alone is not sufficient. One must also document, disease by disease, the level of patient recovery, various quantities measuring the quality of life, and patient satisfaction,” Roine further explains.
The evaluation of the total costs of brain diseases is planned to be carried out during this year.
A national savings program enhancing profitability
Once the cost-effectiveness of therapies is known, taxpayers’ money can be directed to those interventions that offer the greatest health benefits. Roine promotes not only the establishment of the national brain health program but also its adoption by the Finnish government into their program.
”We do not intend to redraft current care guidelines or advise hospital districts. Rather, we are talking about the top-level national level goals,” Roine emphasizes.
Regarding the data-based efforts invested into reducing the incidence of brain diseases, it would be possible to determine concrete outcomes of the recommended interventions.
“We are not asking for more funding; on the contrary, this is about creating a national savings program,” he underlines. “The objective of the program is to prevent and treat brain diseases in the most cost-efficient manner and, subsequently, to maintain Finland’s national brain capacity at as productive levels as possible. The Norwegians are forerunners in this regard: a similar program has been implemented by their Ministry of Health in cooperation with the Norwegian Brain Council.”
One robust way of cooperation is to influence decision-makers by organizing seminars on the topic in collaboration with other organizations. Roine foresees Neurocenter Finland playing the role of the initiator in such cooperative efforts.
“After all, brains are our most important national capital.”
Finnish Brain Council is a non-profit umbrella organization that represents both mental health and brain health associations. The main objective is to enhance brain health as well as research on brain diseases in Finland. Finnish Brain Council represents Finland at the European level and is a member of the European Brain Council.
Risto O. Roine is Professor of Neurology, MD PhD Medicine and Surgery.