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Neurological diseases represent the most significant epidemiological burden on society in terms of broadly understood disability, and are among the most important in terms of mortality. They are the leading causes of permanent disability among adult residents of Poland—especially young adults—as well as cognitive dysfunction-related impairments such as dementia, professional inefficiency, and absenteeism.

On the other hand, recent decades have seen a massive and, in some cases, spectacular development of therapeutic possibilities for these conditions. Today, we—medical professionals specializing in neurology—are able to significantly reduce this burden, which is already objectively visible in data from our country, such as those published by ZUS regarding patients with multiple sclerosis.

Investment in neurology is a highly profitable investment in society as a whole. At this stage of developing our discipline—understood as ensuring the best possible outcomes from therapies already available—we should focus, among other things, on an efficient pre-hospital and early hospital management system for acute strokes. This applies not only to revascularization treatment of acute ischemia, but also to early etiological diagnosis, secondary prevention, rehabilitation, and specific treatment of certain intracranial hemorrhages.

Some drug programs should be placed under the umbrella of coordinated care, at least to the extent allowed by our current staffing and infrastructure resources. This should include elements of referral systems with greater involvement of outpatient specialist care (AOS), but always under clinical monitoring by a specialized center. This must be accompanied by a significant increase in funding for the administration of neurological drug programs and the aforementioned additional care—also to avoid losing part of the potential of medications and therapeutic technologies that we already use and reimburse.

Currently, Poland is efficiently incorporating new, innovative drugs into our therapeutic portfolio. Decisions are naturally based on scientific data and clinical—expert—experience. We strive to ensure that every new drug registered by the European Medicines Agency is considered by Polish agencies for inclusion in our “formulary” under some reimbursement category. This pathway enables systematic and systemic construction of our therapeutic portfolio.

In the strategy for developing pharmacotherapy for brain diseases over the coming year(s), we have a list of priorities: separately for acute strokes—emergency treatment, and separately for chronic diseases—disease-modifying drugs, including multiple sclerosis, myasthenia gravis, and chronic migraine. A particularly important area is care for patients with progressive dementia-related diseases. It is good that a general plan for developing care in this area has been created, but we need an agenda for implementing specific systemic solutions. These should include early identification of patients with such disorders and proper etiological diagnosis, because we can already significantly slow the progression of some of these conditions. More importantly, we are now entering a new level of development in this major epidemiological therapeutic area—we should not delay, especially in light of the consequences of the unfavorable demographic trend in our country.

👨‍⚕️ Prof. Bartosz Karaszewski, MD, PhD National Consultant in Neurology Chair of the Cerebrovascular Diseases Section of the Polish Neurological Society Head of the Department of Neurology and Adult Neurology Clinic, Faculty of Medicine, Medical University of Gdańsk Head of the Adult Neurology Clinic, University Clinical Center in Gdańsk