The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)--quality of life during the first 4 months after fracture.

UNLABELLED: The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. INTRODUCTION: The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. METHODS: ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. RESULTS: The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. CONCLUSIONS: The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.

Resource allocation to brain research in Switzerland.

QUESTIONS UNDER STUDY: This study represents a first attempt at estimating Swiss resource allocation to brain research including both public and private spending. METHODS: In order to estimate public spending (by governments and charities) a survey was conducted to evaluate the way brain research is funded across Europe and especially in Switzerland. Industry funding was measured using different approaches including a survey of pharmaceutical expenditures and the costs of developing new drugs. RESULTS: Private spending is at a reasonable level because a highly developed Swiss pharmaceutical industry invests significantly in this branch of science. However, public spending is at a low level compared to other European countries, although Switzerland is the only European country where the total funding per capita exceeds that of US funding. CONCLUSIONS: A detailed investigation of Swiss resource allocation to different branches of biomedical research is warranted. Brain research should be an important part of such a study. The United States and the European Union have selected brain research as one of their priority areas within health related research. The present figures indicate that this may also be justified in Switzerland.

Funding of headache research in Europe.

Migraine costs European Society 27 billion Euro per year. Other headaches may account for a similar amount. Given this enormous impact, the question arises as to whether the funding of research efforts in this field are sufficient. A recent European study called the Resource Allocation to Brain Research in Europe (RABRE) examined funding of brain research. Identified charities and Government agencies in Europe filled out a questionnaire regarding their funding of brain diseases. Industry spending was evaluated by three different previously validated methods. In the present report, detailed results are presented for migraine and other headaches. In 2004, migraine research was funded by nearly 315 million Euro . Of this, 308 million Euro was invested by the pharmaceutical industry, whereas public funding was estimated at 7 million Euro . No funding was identified for non-migraine headache disorders. Of the public spending, 714,000 Euro came from private foundations. There was a very large difference between different European countries in the funding of headache research. When public funding was compared with the cost of different brain disorders, migraine funding was in the middle range. This was due to relatively large industry funding. Compared with societal costs, migraine received the least public funds amongst all brain disorders, i.e. 0.025%. We conclude that migraine attracts reasonable interest from the pharmaceutical industry, but Governmental and charity funding is extremely low and no funding was identified for non-migraine headache disorders. Considering the huge economic impact of these disorders, public funding of research into migraine and other headaches should be greatly increased in the future.

Resource allocation to brain research in Denmark: an example for other European countries.

This study represents a first attempt at estimating Danish resource allocation to brain research including both public and private spending. It appears that private spending is at a reasonable level because a highly developed Danish pharmaceutical industry invests significantly in this branch of science. However, public spending is at a low level compared with several other European countries with a similar economic status. As for other European countries the funding is very low compared with the USA. Dedicated national investigations of the resource allocation to different branches of biomedical research are warranted. Brain research should of course be an important part of such studies. The USA and the European Union have selected brain research as one of their priority areas within health-related research. The present figures indicate that this is highly justified and should be copied in Denmark and in all other European countries.

Resource allocation to brain research in Europe (RABRE).

This article is a markedly condensed summary of a longer report [Resource allocation to brain research in Europe (RABRE), part 2] that is simultaneously published on line: (i) as supplementary material linked to this European Journal of Neuroscience article (http://www.blackwell-synergy.com/loi/ejn) and (ii) on the website of the European Brain Council (http://www.europeanbraincouncil.org/publications). We have recently shown that brain diseases account for 35% of the overall disease burden and cost European society almost euro 400 billion per year (a billion is understood to mean one thousand million throughout this report). The aim of the present study was to estimate funding for brain research in Europe and the cost-benefit of further investments in this area of research. The assessment of funding included public sources (governmental agencies plus charities) and industry funding. The assessment of publicly financed research support for brain research was based on a comprehensive survey, and industry investment in brain research was assessed based on published data on pharmaceutical development. The total funding of brain research in Europe was estimated at euro 4.1 billion in 2005, of which public grants amounted to < euro 900 million. Thus, industry funding accounted for 79%. Although cancer only incurred 50% of the cost of brain diseases in 2005, public grants for cancer research were almost twice as high as the public financial support of brain research. US-based funding of brain research was almost four times higher than European funding. We assessed the cost-benefit of further investment in brain research using different methods. They all showed that increased investment in brain research is likely to be highly cost-effective. We conclude that European spending on brain research, particularly public spending, is low compared to other fields of research and to the US, and that increased investment in brain research seems warranted.