The economic burden of functional neurological disorder.

We provide an analysis of the economic burden of functional neurological disorder (FND). For a condition that is complex to diagnose and treat, estimating its true prevalence and incidence can be challenging. This estimation challenge has economic implications in terms of directing healthcare and other resources to mitigate the burden of FND. Existing economic analysis is limited, with most studies ignoring the wider social costs of FND, which are believed to be considerably higher than direct healthcare costs. This, in turn, affects the reliability of cost-effectiveness analysis. Using a number of existing studies, we provide an analysis of some of the challenges in estimating the true costs of FND. We revisit the debate around the appropriateness of cost-effectiveness analysis using quality-adjusted life years (QALYs) versus other frameworks, particularly generalised risk-adjusted cost-effectiveness (GRACE), in diseases like FND and its equity implications. Finally, we discuss how the probable underestimation of the economic burden of FND stifles innovation and dampens investment in promising technology. This article is part of the discussion meeting issue 'Digital healthcare for the management of functional neurological disorders'.