Estimating global direct health-care spending on neurological and mental health between 2000 and 2019: a modelling study

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BACKGROUND: The burden of brain disorders, including neurological and mental health conditions, is rising globally. Despite the increasing burden, literature quantifying global spending patterns on care services for brain disorders is sparse. Our aim was to quantify the direct spending on health care associated with brain disorders between 2000 and 2019. METHODS: In this modelling study, we estimated direct spending for 24 brain disorders across 204 countries in males and females across 18 age groups between 2000 and 2019. We used disease prevalence and incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, relative price of care estimates from the Institute for Health Metrics and Evaluation Disease Expenditure Project, and type of care-specific and country-specific adjustment factors from the National Health Accounts, to develop estimates of direct health spending on brain disorders. We adjusted our estimates using a hierarchical linear mixed-effects model regression. FINDINGS: We estimated US$1·7 trillion (95% uncertainty interval 1·6-1·9) in direct health-care spending on brain disorders in 2019, in which spending grew annually at 3·5% (3·2-3·7) since 2000. Direct spending on services for neurological disorders accounted for 51·8% (48·4-55·6) of total spending in 2019, in which inpatient care services represented the largest fraction of overall spending on brain health globally. Older adults aged 50-74 years had the highest spending on care services and the steepest growth. There were minimal sex differences overall. INTERPRETATION: Direct spending on brain health contributes to a substantial economic burden for societies. In light of an increasingly ageing global population, it is crucial that policy makers prioritise interventions that support households affected by brain disorders. FUNDING: Roche Holdings and Genentech.

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