Objectives-Brain tumours cause considerable concern due to a high mortality and there are increasing eVorts to provide adequate care, sometimes outside hospitals. Health care utilisation, direct costs of care, and the indirect social cost of morbidity and early mortality caused by brain tumours in Sweden in the year 1996 was analysed. Methods-Quantification of ambulatory care, care in hospital, long term and palliative/terminal care, drug consumption, temporary as well as long term morbidity, and mortality from comprehensive national data sources. Direct costs were calculated using 1996 charges. Indirect costs were calculated by sex and age specific salaries. A sensitivity analysis considered the impact of alternative estimates of each item. Results-Indirect costs were 75% of the total and were caused mainly by early mortality. Direct costs were predominantly for care in hospital, long term care, and home health care. Among direct costs, astrocytomas III-IV and meningiomas accounted for 42% and 30% respectively. Conclusions-The cost of illness from brain tumours reflects the characteristics of these malignancies. Despite their low incidence rate, the economic impact caused by high mortality among young persons is a predominant trait. Costs of acute hospital care and also long term care and home care are considerable. (J Neurol Neurosurg Psychiatry 2000;69:792-798) Keywords: brain neoplasms; cost of illness; Sweden Each year in Sweden, primary brain tumours account for 3% of the tumour incidence.1 The diagnostic investigation and treatment for these patients is regionalised to six university hospitals, providing comprehensive assessment of each patient by specialists in neurology, neurosurgery, oncology, and neuroradiology.The prognosis depends mainly on age at diagnosis and the histological type of the tumour with crude absolute survival during the first year after diagnosis ranging from 70% for type II astrocytomas, 45%-60% for type III astrocytomas, and 20%-27% for glioblastomas. Meningiomas have a crude survival for the first year of well above 90%. Over the years, the prognosis for brain tumours has improved slightly.
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