Evaluation of full costs of care for patients with Alzheimer's disease in France: the predominant role of informal care.
OBJECTIVE
It is crucial that the cost of Alzheimer's disease be evaluated, from a societal perspective, since the number of patients is expected to increase dramatically in the coming decades. This assessment of the full cost of care for community-dwelling patients with Alzheimer's disease in France also addresses the factors associated with informal care, its predominant component.


METHODS
From 2009 to 2010, 57 patient/informal caregiver pairs were interviewed using the Resource Utilization in Dementia questionnaire, adapted to provide a micro-costing approach of the overall care process. Both the opportunity cost method and the proxy good method were used to value informal care. Ordinary least square regression was performed to determine factors associated with informal care.


RESULTS
Average total monthly costs were €2450 with the proxy good method and €3102 with the opportunity cost method. Living with the patient, severity of dementia and hours spent on formal care were significantly associated with informal care time.


CONCLUSIONS
Since French allowance cannot cover all formal and informal non-medical costs, the choice for policy makers is either to spend more on formal care or to develop family care by investing in supportive programmes for informal caregivers.
Département SHSC, Ecole des Hautes Etudes en Santé Publique, Avenue du Pr Leon Bernard, CS 72, Rennes, France; Laboratoire Santé Environnement Vieillissement, Hôpital Sainte Périne, 49 rue Mirabeau, 75016 Paris, France. Electronic address: chloe.gerves@ehesp.fr.
Chloé
C
Gervès
Université Paris Descartes-LIRAES (EA4470), 45 rue des Saints-Pères, 75006 Paris, France. Electronic address: pauline.chauvin@parisdescartes.fr.
Pauline
P
Chauvin
Département SHSC, Ecole des Hautes Etudes en Santé Publique, Avenue du Pr Leon Bernard, CS 72, Rennes, France. Electronic address: martine.bellanger@ehesp.fr.
Martine Marie
MM
Bellanger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D017028:Caregivers / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000191:economics* / Q000706:statistics & numerical data; D012720:Severity of Illness Index
Alzheimer's disease; Formal care; France; Informal care; Opportunity cost method; Proxy good method