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«EUROPEAN CHARTER OF THE RIGHTS OFCITIZENS OVER 65 WITH CHRONIC PAIN AND VIEWSOF THE MEMBERS OF THE EUROPEAN PARLIAMENT»

SIHA – Senior International Health Association is the federation that brings together the associations involved at European and international level on matters concerning elderly people with the aim of coordinating their action on health.

In a scenario where an aging population is both an achievement and a phenomenon with a strong impact on European and Western social systems, SIHA’s core aims are:

• the promotion of active aging;• full access to drugs and care for all citizens, and primarily

the most vulnerable and dependent;• the activation of a constructive dialogue between all

stakeholders in the health system (patients, general practitioners, pharmacists, scientific societies and institutions) for the development of health systems suitable for elderly;

• the development of a digital culture for senior population granting a better quality of life.

With these aims, SIHA works every day to create a network intending to promote objective interests for the protection of both patients and health systems.

About Siha

In their review, Moore et al mention that most publications report prevalence rates of 10% to 30%. They calculated the average prevalence weighted by study size and came to the number of 22% persons suffer from chronic noncancer pain chronic in Europe.

This is in good agreement with another study (Redi et al), with about 170,000 subjects that reported a 1-month point prevalence of 19% with moderate or severe pain and a prevalence of any chronic pain of 17% (Reid et al 2011).

As of 1 January 2015, the population of the EU is about 508.2 million people, this projects that more than 100 million Europeans who from moderate-to-severe chronic non-cancer pain.

The number of days spent in hospital is higher in patients with chronic pain; estimates include 9 additional days in Denmark, 1.3 days in Germany and 0.3 in Europe. These very wide differences probably reflect different practices in time and place.

Overall, costs for treatment for chronic noncancer pain patients are at least 2.6 times higher than for those without chronic pain.

Chronic Pain in Europe

In Denmark, around 16% suffered from moderate to severe chronic noncancer pain and 20% suffered from any chronic noncancer pain, including mild pain.In Sweden, a moderate to severe chronic noncancer pain sample reported a prevalence estimate of 18% .

Results from several studies support the statement that chronic pain has an economic impact on society, health care resources, and the individual. Around 9 workdays per 6 months are lost due to chronic pain in Denmark, and there is also an association between chronic pain and disability pensions.

Chronic pain sufferers in Denmark and Sweden appear to be undertreated.

For Denmark, literature indicates that only 19% of sufferers of any chronic pain and 14% of those with moderate to severe chronic pain have ever seen a pain management specialist.

About three quarters of those with moderate to severe chronic pain report inadequate pain control with prescription pain medication, and 90% of opioid users for general chronic pain reported inadequate pain control. About half of chronic pain patients are unsatisfied with the treatment they receive.

In Sweden, only 12% of patients with moderate to severe chronic pain reported seeing a pain management

Chronic pain in Denmark and Sweden

Moderate to severe chronic pain: 14.5 to 25%Severe chronic pain: 3.5 to 5.7%

Considering a prevalence of moderate/severe chronic pain of 14.5-25%, average monthly direct costs between 150 and 2200 €, and a total of direct and indirect costs that exceeds 2% of the gross domestic product, chronic pain clearly ranks among the most urgent health care problems in Germany.

In spite of these expenses, 13-51% of patients do not receive adequate pain control, and there is a big gap between treatment recommendations on one hand and treatments actually given to patients on the other hand

Chronic Pain in Germany

Prevalence of chronic pain in the Italian population: 21.7%41% of patients report they have not received adequate pain control.

49% of home care patients and 31% of those assisted in DH has experienced pain. 25.1% of the sample suffers severe pain (especially among the home care patients).

43 million blisters of FANS are consumed in Italy every year to cure pain. 68 times out of 100 pain is controlled with a FANS (European average: 44%).

The annual cost for pain control treatment in Italy is 4,556 € per patient. 3,156 € (69%) are imputable to productivity losses (days off work)1,400 € are direct costs borne by the NHS.

Chronic pain in Italy

In Spain, three epidemiological studies of large samples had already been published. One of these was carried out more than 10 years ago, showing a prevalence of pain longer than 3 months of 23.4% and being much more common in women (31.4%) than in men (14.8%) and in people older than 65 years (39.5%) than younger people (8.5%).

The other two studies were more recent, and they showed a prevalence ranging from 12% to 17.2%.

However, the validity of the information reported in these studies has been brought into question due to the inadequate description of the study setting, study participants, eligibility criteria, statistical methods.

Chronic Pain in Spain

Mean cost per chronic pain patient was estimated at €5,665 per year across all grades of pain, with mean costs increasing according to the severity of pain.

A small proportion of patients account for the bulk of costs-the top 5% most expensive patients accounted for 26.4% of costs, with a mean cost per patient of €29,936, and the 10% most expensive patients were responsible for 42.8% of all costs.

Total cost for individuals aged 20 and above was estimated at €5.34 billion per year, or 2.86% of Irish GDP in 2008. Those with clinically elevated depression scores had costs that were twice as high as people who scored below the depression cut-off score. Chronic pain services in Ireland are generally underresourced.

Improved coordination and better management of patients via interdisciplinary pain rehabilitation program is essential and may offer a means of reducing the sizeable economic burden of chronic pain.

Cost of Chronic Pain in Ireland

Chronic Pain Direct Cost in EuropeCountry GDP %cost forchronic pain onGDP Total Cost %DirectCost Totaldirect cost Directcost ofover65Austria 317,25 2,0% 6,35 42,7% 2,71 2,06Belgium 388,31 2,0% 7,77 42,7% 3,31 2,53Bulgaria 40,93 2,0% 0,82 42,7% 0,35 0,27Croatia 43,96 2,0% 0,88 42,7% 0,38 0,29Cyprus 17,72 2,0% 0,35 42,7% 0,15 0,12CzechRepublic 160,96 2,0% 3,22 42,7% 1,37 1,05Denmark 250,86 2,0% 5,02 71,0% 3,56 2,71Estonia 17,64 2,0% 0,35 42,7% 0,15 0,11Finland 199,10 2,0% 3,98 42,7% 1,70 1,30France 2.091,39 2,0% 41,83 42,7% 17,85 13,60Germany 2.749,87 2,0% 55,00 46,3% 25,46 19,41Hungary 98,69 2,0% 1,97 42,7% 0,84 0,64Ireland 172,79 2,9% 4,94 52,0% 2,57 1,96Italy 1.628,28 2,3% 37,45 30,8% 11,52 8,78Latvia 22,08 2,0% 0,44 42,7% 0,19 0,14Lithuania 32,95 2,0% 0,66 42,7% 0,28 0,21Luxembourg 43,81 2,0% 0,88 42,7% 0,37 0,29Malta 6,90 2,0% 0,14 42,7% 0,06 0,04Netherlands 640,65 2,0% 12,81 42,7% 5,47 4,17Poland 386,21 2,0% 7,72 42,7% 3,30 2,51Portugal 169,68 2,0% 3,39 42,7% 1,45 1,10Romania 131,85 2,0% 2,64 42,7% 1,13 0,86SlovakRepublic 72,19 2,0% 1,44 42,7% 0,62 0,47Slovenia 36,01 2,0% 0,72 42,7% 0,31 0,23Spain 1.055,43 2,0% 21,11 42,7% 9,01 6,87Sweden 423,34 2,0% 8,47 41,0% 3,47 2,65UnitedKingdom 2.035,35 2,0% 40,71 15,0% 6,11 4,65Totale 13.234,2 2,0% 271,05 42,7% 115,68 88,16*Amounts in billions of €

Roberto MessinaSIHA CEO ItalySince 2006 is President of Senior Italia FederAnziani:

Federation of non-profit association with 3,5 million members over 65, which protects the rights, quality of life, prevention and treatment of diseases of the elderly, and promotes active aging at national and international level.

Co-founder of the Popular Court of Justice for right to Health:

Popular Court of Justice for right to Health:National organization by FederAnziani acting with the aim of protecting the right to health of citizens and create a health care system more accessible, especially for most vulnerable people. The work of the Court of Justice is done through a sectoral and accurate assessment of the criticality of the National Health System, the formulation of concrete and sustainable solutions and the optimization of economic resources. National and international Medical-Scientific Societies, the General Medicine Territory Committee, five University Economy Faculties, Government Institutions, the Ministry of Health, the Primary Health Institution and AIFA (Italian Drug Government Agency) work together within the Court of Justice for the creation and sharing of best practices in health care, to improve the evolution of the National Health System for maximum protection of all citizens, with special attention to the most vulnerable, chronic, cancer patients and to the disabled.

Profiles

«EUROPEAN CHARTER OF THE RIGHTS OFCITIZENS OVER 65 WITH CHRONIC PAIN AND VIEWSOF THE MEMBERS OF THE EUROPEAN PARLIAMENT»

Symposium - Salon MepModerator: Marcello Campo - Ansa Bruxelles

14.00 Welcoming of guests and document distribution of the «European Charter of the Rights of Citizens Over 65with Chronic Pain»

14.15 The voice of the patients• Heather Clarke - Executive Director (Acting) European

Federation of Neurological Associations• Hans-Karl Duwenkamp - German Cluster Headache Support

Group 14.20 The clinical point of view in different countries• Prof. Gianni Colini Baldeschi – President of the Italian Chapter

of the International Neuromodulation Society, Member of Ministerial Pain Committee Italy

• Prof. Jean-Pierre Van Buyten - Director Multidisciplinary Pain Center AZ Nikolaas Belgium

14.30 The European Charter• Elio D’Orazio - President SIHA Senior International Health

Association Roberto Messina – President Senior Italia FederAnziani

• Joop Van Griensven – President Pain Alliance Europe 14.45 Views of the members of the European Parliament• Hon. Giovanni La Via, Hon. Gianni Pittella, Hon. Maria Arena,

Hon. Mercedes Bresso, Hon. Alberto Cirio, Hon. Sergio Cofferati, Hon. Santiago Fisas Ayxiela’, Hon. Elisabetta Gardini, Hon. Antonio Panzeri, Hon. Aldo Patriciello, Hon. Claudia Tapardel

Press Conference 15.30-16.00 - PHS0a50

Event - 11/11/2015