BACKGROUND: There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families. METHODS: This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community. RESULTS: The societal burden of AD, composed of public, patient, and informal care costs, was about €20,000/yr. Out of this, the cost borne by the public sector was €4,534/yr. The main driver of public cost was the national cash-for-care allowance (€2,324/yr), followed by drug prescriptions (€1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at €13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure. CONCLUSION: The burden of AD reflects the structure of Italian welfare. The families predominantly manage AD patients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org ( TRIAL REGISTRATION NUMBER: NCT01700556).
RCT Entities:
BACKGROUND: There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families. METHODS: This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community. RESULTS: The societal burden of AD, composed of public, patient, and informal care costs, was about €20,000/yr. Out of this, the cost borne by the public sector was €4,534/yr. The main driver of public cost was the national cash-for-care allowance (€2,324/yr), followed by drug prescriptions (€1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at €13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure. CONCLUSION: The burden of AD reflects the structure of Italian welfare. The families predominantly manage ADpatients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org ( TRIAL REGISTRATION NUMBER: NCT01700556).
Authors: Agneta Malmgren Fänge; Steven M Schmidt; Maria H Nilsson; Gunilla Carlsson; Anna Liwander; Caroline Dahlgren Bergström; Paolo Olivetti; Per Johansson; Carlos Chiatti Journal: Trials Date: 2017-02-09 Impact factor: 2.279
Authors: Maria Gabriella Melchiorre; Mirko Di Rosa; Francesco Barbabella; Norma Barbini; Fabrizia Lattanzio; Carlos Chiatti Journal: Biomed Res Int Date: 2017-02-07 Impact factor: 3.411
Authors: Youssef H El-Hayek; Ryan E Wiley; Charles P Khoury; Ritesh P Daya; Clive Ballard; Alison R Evans; Michael Karran; José Luis Molinuevo; Matthew Norton; Alireza Atri Journal: J Alzheimers Dis Date: 2019 Impact factor: 4.472
Authors: Lisanne I van Lier; Henriëtte G van der Roest; Vjenka Garms-Homolová; Graziano Onder; Pálmi V Jónsson; Anja Declercq; Cees Mpm Hertogh; Hein Pj van Hout; Judith E Bosmans Journal: Health Serv Insights Date: 2021-06-21