Fetal alcohol spectrum disorder: a systematic review of the cost of and savings from prevention in the United States and Canada

Abstract

Background and aims Fetal alcohol spectrum disorder (FASD) is a preventable condition that imposes a significant financial burden on societies. Funding of FASD prevention is a small portion of the total expenditures associated with FASD. This paper aimed to review the literature on the costs of and savings from prevention of FASD and present a model for the United States and Canada of projected savings based on expansion of existing evidence‐based prevention models. Methods A systematic review of published literature on the cost of FASD prevention was conducted and experts in the field were interviewed. Studies that reported the cost of primary prevention of FASD were eligible for further consideration. Results Applying evidenced‐based prevention programs to women at highest risk to have a future child with FASD greatly reduces the cost of prevention. In the United States, one case of FASD can be prevented for as little as USD $20 200 – 47 615. Cost of prevention is considerably less expensive than cost of care for a case of FASD. Conclusion Expansion of risk‐based prevention strategies for fetal alcohol spectrum disorder in the United States and Canada would be an economically efficient and worthwhile investment for society.

Fetal Alcohol Spectrum Disorder: Can We Change the Future?

“…How could we afford this? We now have a potential model of how to target our funding for FASD prevention (Greenmyer et al, 2019). If we emphasize the implementation of prevention activities in high‐risk subpopulations, we are likely to enhance the impact of our FASD prevention funding.…”

“…If we emphasize the implementation of prevention activities in high‐risk subpopulations, we are likely to enhance the impact of our FASD prevention funding. Strategically implementing national funding for FASD prevention can have tremendous benefits, as it is known to be over 1,000 times more cost‐effective to identify a woman who has already has a biological child with FASD, than to implement interventions with women of childbearing age who consume alcohol (Greenmyer et al, 2019).…”

Alcohol use in pregnancy and its impact on the mother and child

“…estimated mean annual cost for children with FASD to be $22,810 and $24,308 for adults. Residential costs for children were 4 times greater than adults but costs of lost productivity were 6.3 times higher in adults [197]. Preventing one case of FASD could be as little as $20,000–47,615, which is equal to or even considerably less than the annual cost of any patient with FASD.…”

The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

“…There has been much interest in the relationship between alcohol misuse use during pregnancy and deleterious neonatal outcomes, particularly in terms of links to associated developmental disorders, such as foetal alcohol syndrome [1][2][3]. Comparatively under-researched within the pregnancy and childbirth context is the relationship between personality disorder and impoverished neonatal outcomes, a perhaps surprising observation given the relationships observed between alcohol misuse during pregnancy, personality disorder and personality traits [4,5].…”