Discussion summary: The global burden of headache

摘要

To get more resources to headache treatment and research, Dr Tim Steiner (London, UK), president of the Global Campaign, argued that it is important to show that investments in headache care will also give economic returns, in terms of reduced indirect costs and less wastage of health resources. There was not universal agreement about the economic argument. Professor Jes Olesen, (Copenhagen, Denmark) contended that most politicians in the health sector are little interested in economic gains that do not lead to lower expenditures in their budgets, which the possible saving related to better handling of headaches will not do. He meant that the high prevalence of Medication-Overuse Headache (MOH) might be the best argument to get more resources to headache. This led to an interesting discussion about the economic impact of and the optimal handling of chronic headache including MOH. Dr Fred Sheftell, (Connecticut, USA), argued that patients with medication overuse might be more productive with than without frequent analgesic medication, and in the same vein, Ann Scher, (Maryland, USA), said that there is also a cost to the under-treatment of chronic headache. It was also stated that continuous pain was possibly less costly than frequent or daily episodic headache because the latter may be more disruptive on ongoing activity. As there was now some evidence showing that frequent or chronic headache could lead to permanent changes in the brain, this would make a strong case for better treatment of headache patients to avoid long-term sequelae but these results needs confirmation.