Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease: A Structured, Rapid Review

Abstract

Background: Alzheimer’s Disease is the most common cause of dementia, affecting memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. AD is predicted to increase healthcare spending and costs associated with formal and informal caregiving. The aim of this study was to identify and quantify the contribution of the different cost components associated with AD. Methods: A structured literature review was conducted to identify studies reporting the economic burden of Alzheimer`s Disease beyond the healthcare setting. The search was conducted in Medline, Embase and EconLit and limited to studies published in the last 10 years. For each identified cost component, frequency weighted mean costs were calculated across countries to estimate the percentage contribution of each component by care setting and disease severity. Results obtained by each costing approach were also compared. Results: For community-dwelling adults, the percentage of healthcare, social care and indirect costs to total costs were 13.9%, 17.4% and 68.7%, respectively. The percentage of costs varied by disease severity with 26.0% and 10.4% of costs spent on healthcare for mild and severe disease, respectively. The proportion of total spending on indirect costs changed from 60.7% to 72.5% as disease progressed. For those in residential care, the contribution of each cost component was similar between moderate and severe disease. Social care accounted on average for 85.9% of total costs. Conclusion: The contribution of healthcare costs to the overall burden was not negligible; but was generally exceeded by social and informal care costs.

Associations of Alzheimer’s disease with inpatient hospital costs and with quality-adjusted life years: Evidence from conventional and Mendelian randomization analyses in the UK Biobank

“…We also did not have access to carer costs, which are a very significant issue for most Alzheimer’s disease patients and their families (33). While research continues on the most appropriate way to account for carer burden in economic evaluation (34, 35), further evidence on the scale of potential impacts in this group is needed (36-39).…”

Modelling the value of innovative treatments for Alzheimer’s disease in the United States

“…Another study found that 70% of cost-utility analyses for AD and other dementias considered at least some family or caregiver spillover costs, but only 19% considered spillover health effects [31]. A recent literature review of multinational studies found that informal care costs represent approximately 60% of total costs for patients with early stages of AD, increasing to 72.5% for patients with severe AD [32]. Although cognitive function has been identified as the main driver of societal costs of patients with AD [33], both cognitive decline and physical disability were found to be predictors of increased informal care costs [34].…”

“…Although cognitive function has been identified as the main driver of societal costs of patients with AD [33], both cognitive decline and physical disability were found to be predictors of increased informal care costs [34]. Moreover, the need for social and informal care is already higher in patients with mild cognitive impairment likely due to AD than age-matched controls and increasing further in patients with AD dementia [32].…”

Protective effect of irisin against Alzheimer’s disease

“…AD is the first to blame when it comes to disability in the elderly, and its incidence grows exponentially with age. It also requires higher treatment costs compared with heart diseases and cancers, increasing the financial burden on the global economy and patients’ families ( 3 ). Dr. Alois Alzheimer first reported AD and its features of progressive memory loss and other cognitive impairments as early as 1907 ( 4 ), but no definitive therapy was discovered.…”