The economic impact of moderate stage Alzheimer's disease in Italy: Evidence from the UP-TECH randomized trial

Research output: Contribution to journalArticle

Abstract

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).

Details

Authors
  • Gianluca Furneri
  • Joseph M Rimland
  • Federica Demma
  • Franco Bonfranceschi
  • Laura Cassetta
  • Filippo Masera
  • Antonio Cherubini
  • Andrea Corsonello
  • Fabrizia Lattanzio
  • Diletta Baldassarri
  • Luigina Bitti
  • Aurora Carosi
  • Maila Sabbatini
  • Elisabetta Paolasini
  • Tania Fiori
  • Cinzia Fronzi
  • Simona Giacchetta
  • Valeria Giacomini
  • Laura Giovagnoli
  • Giuli Lattanzi
  • Anna Maria Manca
  • Ida Marinelli
  • Valeria Pigini
  • Marina Pignotti
  • Maria Chiara Proietti
  • Antonia Quarticelli
  • Martina Rovedi
  • Letizia Tasso
  • Valentina Valeri
  • Andrea Antonioli
  • Mariella Barabucci
  • Mara Bassani
  • Paola Bollettini
  • M. Cristina Bruttapasta
  • Carla Buccolini
  • Rosa Carangella
  • Franca Carboni
  • Daniela Ceccolini
  • Patrizia D'Incecco
  • Mariangela Di Felice
  • Lara Dini
  • Giordano Gioia
  • Giuseppe Di Prima
  • Giancarlo Giusepponi
  • Cesarina Lanciotti
  • Alessia Loffreda
  • Oriana Luciani
  • Laura Mariani
  • Francesco Mastrorilli
  • Roberto Moroni
  • Izabela Piatkowska
  • Roberta Rucoli
  • Giampaola Scoccia
  • Nives Teodori
  • Tiziana Tonelli
  • Rossano Angeloni
  • Rosa Anna Bratti
  • Giuseppe Bonafede
  • Severino Lorenzetti
  • Cristina Paci
  • Giovanna Picciotti
  • Donella Pezzola
  • Vincenzo Rea
  • Vittorio Scialè
  • Mario Signorino
  • Francesca Sorvillo
  • Pia Francesca Tomassini
  • Alessia Ciccola
  • Loena Cionfrini
  • Daniela Alessandrini
  • Antonio De Santis
  • Brunetta Formica
  • Giuliano Tacchi
  • Silvia Tortorelli
  • Gemma Marchegiani
  • Giovanni Pozzari
  • Giovanni Santarelli
  • Dario Bartolucci
  • Giorgio Caraffa
  • Filippo Cavallo
  • Lucia Di Furia
  • Antonio Lacetera
  • Claudio M. Maffei
  • Lamberto Manzoli
  • Demetrio Postacchini
  • Roberta Bevilacqua
  • Anna Rita Bonfigli
  • Silvia Bustacchini
  • Marina Capasso
  • Patrizia Civerchia
  • Mirko Di Rosa
  • Cinzia Giuli
  • Marzio Marcellini
  • Paolo Marinelli
  • Maria Gabriella Melchiorre
  • Maria Elena Moraca
  • Andrea Principi
  • Cristina Rocchetti
  • Liana Spazzafumo
  • Daniela Vincitorio
  • Krystian Bartulewicz
  • Paolo Olivetti
  • Lorena Rossi
External organisations
  • Italian National Research Centre on Ageing (INRCA)
  • Marche Regional Health Agency
Research areas and keywords

Keywords

  • Alzheimer's disease, caregiver, community-living, cost analysis, RCT, UP-TECH
Original languageEnglish
Pages (from-to)1563-1572
Number of pages10
JournalInternational Psychogeriatrics
Volume27
Issue number9
Publication statusPublished - 2015 Jan 9
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes