EU must end stroke care lottery

Stroke is a major, pan-European, public health concern, but solutions exist to ensure equal access across Europe to quality healthcare and innovative stroke treatments, writes Aldo Patriciello. 

Aldo Patriciello | Photo credit: European Parliament audiovisual

By Aldo Patriciello

02 Nov 2017

Stroke is responsible for over one million deaths per year in Europe. It has significant economic and social implications on survivors, families of stroke victims, and society as a whole. Stroke is estimated to cost the EU economy €45bn a year, almost a third of the EU’s budget in 2017. 

In addition, aging populations throughout the EU are predicted to further increase stroke prevalence and burden on health-care systems. Experts predict a 34 per cent rise in the total number of stroke events in the EU between 2015 and 2035. Therefore, urgent action is needed to reduce the burden of stroke.

On 10 October, I hosted the European Stroke Organisation’s event on access to stroke care and innovation in the European Parliament. During this event, experts highlighted that large disparities persist between member states and regions in respect to stroke survival and remission rates. 


Death rates for strokes are much higher in eastern and central regions than in northern, southern and western regions. In my home country, Italy, patients living in the north are more likely to survive a stroke than their compatriots from the south. This is simply unacceptable.

As the event revealed, these disparities are partly explained by unequal access to effective therapies. Thrombolysis and endovascular treatment (mechanical thrombectomy) are still not routine procedures in several regions and many stroke victims in Europe still don’t have access to acute stroke treatment. This can and should be resolved. 

Stroke diagnosis and rapid treatment time are of the essence. Yet, full coverage by stroke units is still not available in large areas. For instance, the average time to receive treatment in the city of London is 30 minutes. In the south of Italy, it takes hours. 

There is an urgent need to reform our stroke care pathways, and revolutionary developments in stroke treatment such as the take-up of endovascular treatments provide us with a unique opportunity to do so. Stroke management strategies should be put in place to ensure there is an optimal number of stroke units, able to provide a range of interventions improving stroke outcome.

Concrete actions can be taken to bring down barriers to stroke acute treatment and ensure access to quality healthcare - a basic right in the EU. In June, the EU heads of state and government called for increased cooperation between member states in ensuring access to new health technologies, and recommended doing so under best practice frameworks. If we follow this path and improve exchange of best practices, cross-border cooperation and capacity building we can end this stroke care lottery. 

There are many reasons for us to remain hopeful about the future of stroke treatment in Europe. However, action is needed at EU and national level, from stakeholders across the care chain. By recognising stroke care as an EU-wide priority, we will mark a first step towards reducing the incidence and the financial burden of strokes in Europe.


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