With an ageing European population comes an ever increasing societal burden of brain diseases. These illnesses, if managed sub-optimally, cause terrible distress and consume a major proportion of the budgets of healthcare systems. Societal changes also contribute to the growing requirements for the care of those with brain disease. For example, women were traditionally the care-givers in the family structure whose caring was freely given, but their role has changed. Thus, there is an increasing number of people with neurological illness and a decreasing number of care-givers. In addition, the longer we live, the more diseases we acquire.1 Most patients with brain disease are likely to be taking several different types of drugs.
There is also migration across Europe on a larger scale than ever before, but not one country has developed a culturally-competent care programme. In addition, access to medication is very variable: in some countries, there is access to medication and a reimbursement system, while in others, there is access but no reimbursement, or no access to medication at all (data from the National Institute for Health and Clinical Excellence2). Furthermore, the rules for access and reimbursement are not transparent and vary from country to country, sometimes even between different regions within one country. After Europe-wide approval, reimbursement often takes years to obtain and is sometimes not achieved at all, and this is generally a longer process than regulatory approval. Thus, access to Parkinson’s disease (PD) healthcare professionals and medication needs to be improved.
In summary, there is a need to develop strategies to optimise the quality of life of people with PD, but a major obstacle to optimal care in PD is the length of time it takes for patients to have access to new treatments and the best neurological services. This differs considerably across Europe, but is many years wherever the person lives. Manycomplex barriers have to be overcome in the process a new treatment goes through from the laboratory bench to regulatory approval, reimbursement, and becoming a clinically and cost-effective newtherapy for patients. The barriers to access and the role of partnership between stakeholders in overcoming some of these barriers are discussed here in the context of a hypothetical scenario.
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