The economic burden of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis ({CFS}/{ME}): an initial summary of the existing evidence and recommendations for further research

Background: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) describes a condition of chronic weakness that cannot be alleviated by rest and which is associated with lower quality of life and higher healthcare utilization. In Western countries, its prevalence ranges from 0.2% to 1%. Despite the many efforts carried out during recent decades to investigate the nature of this syndrome, there are still uncertainties and controversies with respect to its definition, diagnosis and what constitutes optimal treatment. Some authors suggest that there may be a significant percentage of patients that are not yet diagnosed with this illness, due to the difficulty in identifying the symptoms. Thus, the economic burden of the disease remains unclear, although it is well recognized that the costs associated with CFS are mainly related to productivity loss.Methods: A literature review was conducted to investigate this topic, by considering, with a chronological perspective, the most relevant contributions focussed on the economic costs and consequences of CFS/ME. Results: The literature review describes how the economic burden of CFS has been increasingly considered over recent decades and addresses the aspects of CFS that deserve more attention as this field of study moves forward.Conclusion: The economic burden of CFS has not been well studied, but recent research demonstrates an increasing interest in the direct and indirect costs of CFS on individuals and Society. The need to establish an optimal, person-centered approach to the diagnosis, management and follow-up of CFS, is an imperative for modern medicine, given the relationship between the nature of clinical practice and the costs incurred by CFS. Further research is required to explore this relationship and to define its policy implications.