The cost of somatisation among the working-age population in England for the year 2008-2009.

Medically unexplained symptoms are one of the most commonly encountered symptoms across all healthcare settings. They are also responsible for a large proportion of disability in the workforce and decreased quality of life. These patients represent an important clinical phenomenon with considerable direct and indirect economic consequences.This study aims to calculate the economic burden of somatisation among English adults in 2008-2009.Using existing literature, estimates of prevalence, healthcare use and disability were combined in order to calculate the annual cost of healthcare use and productivity loss associated with these patients in excess of non-somatising patients.Based on the results of our analysis, the incremental health care cost incurred by somatising patients is estimated to be £3 billion. This represents approximately 10% of total NHS expenditure on these services for the working-age population in 2008-2009. The cost of sickness absence and decreased quality of life associated with these patients amounts to over £14 billion.By highlighting the magnitude of this phenomenon at each level of the health system and the considerable impact of non-healthcare costs, this study serves to draw attention to a group of patients who are frequently unrecognised or misdiagnosed by physicians who tend to repeatedly pursue organic possibilities through multiple tests, procedures and operations. As economic perspectives play an increasing role in healthcare planning, the reduction of health care use and improvement of functioning among this group of patients should be a major goal. In order to realise these goals, changed pathways and behaviour in primary and secondary care are needed, along with improved access to psychological therapy services.