EDITORIAL - Economic Impact of CFS

In a recent edition of The Medical Journal of Australia, a study by Dr Andrew Lloyd was published examining the economic impact of CFS in an Australian community (see 'From the Medical Journals' in this Emerge). This is the first CFS study of its type to appear in the medical literature, and is an example of the innovative research conducted by Dr Lloyd and his colleagues over the last six years.

The study focused on the forty-two CFS patients identified in the epidemiological survey conducted in the Richmond Valley in NSW. Financial costs to the government and the private sector resulting from CFS in the forty-two people were calculated for a one year period. Costs taken into account for each patient included (where relevant): hospital and medical services, pharmaceuticals, paramedical services, sickness benefit and invalid pension, income tax foregone and income foregone.

The results of the research bear testimony to the havoc visited by CFS on the lives of the people it affects. In 1988, for each patient, the average number of medical services directly attributable to CFS was as follows: general practitioner visits, 13; specialist consultations, 5; pathology services, 19; and paramedical services, 14. The costs associated with CFS in individual patients in the Richmond Valley are tabulated below. Dr Lloyd extrapolated his figures to the whole Australian population to arrive at a national figure, assuming that the prevalence of CFS throughout Australia is similar to that reported in the epidemiological study of the Richmond Valley. National figures are also tabulated below.

COST OF CFS PER YEAR (1988-89 DOLLARS)

	Cost per person ($)	National cost ($ millions)
Cost to federal government	4068	26
Total cost to government andprivate sectors	9436	59

As can be seen from the table, Dr Lloyd has estimated that CFS costs the Australian community at least $59 million each year. To put this figure into context, it has been calculated elsewhere that Australiaís largest chronic health problem, asthma, costs the community up to $720 million per year. While not in this league, the economic burden of CFS is nonetheless very significant. It is a cost this country cannot afford, especially in the present circumstances.

The way to reduce this cost is to fund research into the illness, so as to improve its diagnosis, understanding and treatment. Money spent on research is an investment, because illness-related costs will be subsequently reduced through a variety of mechanisms. For example, improved diagnostic techniques will reduce the number of visits to doctors and associated pathology tests that usually occur in the earlier stages of CFS. Development of therapies will assist sufferers to get back on their feet, and into the work-force. Naturally, regardless of any economic benefits, research into treatments is of paramount importance to CFS sufferers, who wait patiently for some remedy which will restore their health and sense of well-being.

Funds for research can come from two sources: the private sector, and the government sector. CFS/ME Societies around Australia continue to raise research funds through the private sector with activities such as requests for donations, raffles, submissions, etc. However, the government sector has not yet been seriously targeted by the state-based CFS Societies as a source of research funds. The direct cost of CFS to the federal government is $26 million per year (see table). An investment in CFS research by the federal government of, say, $4 million per year for six years would still be less than one yearís expenditure on the illness, but would ultimately have a major impact on the financial outlay of both government and private sectors. This level of funding for six years would:

• vastly improve CFS diagnostic procedures
• define the extent of CFS in Australia
• increase knowledge of the underlying disease mechanisms
• improve and categorise appropriate CFS management techniques
• introduce a range of properly trialed treatments aimed at getting CFS patients mobile, more comfortable, and at least into part-time work.

These developments would, of course, be aided by research being conducted overseas. It is very unlikely that an outright cure for CFS would result in this time period.

To obtain research funding from the federal government, the CFS/ME Societies in Australia must, collectively and individually, lobby our politicians and bring to their attention all the issues relating to CFS. We must make them aware that they can save a great deal of money in the future by spending a small amount now on medical research. We must put pressure on them. This is the proven method of getting action. It can be a time-consuming and difficult process, but those who put in the best effort get the best results. Increasingly, CFS Societies in other countries are being heard by their governments, and research dollars are starting to flow.

It is now about six years since Dr Lloyd commenced his research into CFS. The output of the Sydney research team since then has been excellent. Fundraising efforts by the state CFS Societies, particularly NSW, have generally been very good, given the health limitations of members and the poor economic conditions prevailing in the last few years. However, those efforts are not nearly enough. They must get bigger. More Australian research groups must be involved in CFS studies to help increase the rate of medical progress. To achieve this end, we need financial help. So, for how many more years are we prepared to suffer in silence before we forcibly make the federal government aware of the horror and waste of CFS, and demand resources for research into an illness which affects not just the thousands of sufferers, but the entire Australian community?

Jim Oakley

Reprinted from Emerge, May 1993.