title: Prospective one-year cost-of-illness study in a cohort of patients with dementia of Alzheimer's disease type in Spain: the ECO study.
abstract: In this study, we analyzed the economic impact of one-year healthcare and non-healthcare resources utilization by patients with dementia of Alzheimer's disease (AD) under usual medical practice in Spain. A one-year, prospective, naturalistic, multicenter cohort study was designed to recruit patients with mild, moderate to severe, and severe AD according to Clinical Dementia Rating scale: the ECO study. Healthcare resources (medical visits, drugs and concomitant treatments, complementary and diagnostic tests, institutionalization and use of home-nursing facilities) and non-healthcare resources (inventory materials, consumables, professional and non-professional caregivers' time for care and supervision) were recorded and valued at 2006 prices. A total of 560 patients with possible/probable AD by DSM-IV-NINCDS-ADRDA criteria were included in the study: 68% women, 77 +/- 6 years old, 29% treatment naïve. Monthly average cost per patient was 1,425.73 euro, and increased 10.08% at the end of the study (baseline monthly cost; 1,316.22 euro). Non-healthcare costs 1059.00 euro, 74.30% of total cost) decreased 4.30 euro/month (0.40%) at the end of the year, while healthcare costs, which presented a total average of 366.66 euro, grew by 136.94 euro in the period (54.06%), mainly due to cost of drugs, nursing home utilization, and institutionalization. The 87.26% of the overall cost (1,244.22 euro) was not financed by National Health Service (NHS), and the majority of this cost corresponded to caregiver-associated cost. The caregiver's total burden represented 70.86% of the overall cost-of-illness. In conclusion, monthly overall mean cost of dementia of AD type was high in Spain (1,412.73 euro). Almost 88% of the cost-of-illness is funded by the patient's own family, adding a financial burden to the suffering of these families.
authors.affiliation: Gaspar Casal Foundation, Madrid, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Coduras
authors.forename: Isabel
authors.initials: I
authors.lastname: Rabasa
authors.forename: Ana
authors.initials: A
authors.lastname: Frank
authors.forename: Felix
authors.initials: F
authors.lastname: Bermejo-Pareja
authors.forename: Secundino
authors.initials: S
authors.lastname: López-Pousa
authors.forename: Jesús-María
authors.initials: JM
authors.lastname: López-Arrieta
authors.forename: Juan
authors.initials: J
authors.lastname: Del Llano
authors.forename: Teresa
authors.initials: T
authors.lastname: León
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics* / Q000628:therapy; D015331:Cohort Studies; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors