Integrating intangible costs into societal cost estimates of Alzheimer's disease.

Abstract

BackgroundAlzheimer's disease (AD) is associated with considerable economic burden, the full extent of which can be challenging to quantify from a societal perspective.ObjectiveTo estimate the total societal cost of AD in the United States by integrating direct costs, out-of-pocket expenses, indirect costs to caregivers, costs to business, and intangible/emotional costs to patients/caregivers across the disease continuum from mild cognitive impairment (MCI) to severe AD.MethodsIntangible costs were derived from a patient-caregiver survey. Other indirect costs were from a Health and Retirement Study (HRS) analysis; direct costs were from the literature. We estimated integrated societal cost per patient per month (PPPM) for MCI and AD (mild/moderate/severe). Negative binomial regression of indirect costs examined associations with severity, adjusting for baseline characteristics.ResultsIntegrated societal costs PPPM were $4176 for MCI and $7873 for AD ($6,634, $7,291, and $9287 for mild, moderate, and severe, respectively); intangible costs represented 24-32% of societal costs. Indirect costs were higher with AD versus MCI (p < 0.001); married status and nursing home residence were associated with lower indirect costs in AD.ConclusionsIntangible costs are a major driver, besides direct costs, of the integrated societal cost of MCI/AD. Societal costs are higher with more severe AD.