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

Chiatti, Carlos LU ; Furneri, Gianluca; Rimland, Joseph M; Demma, Federica; Bonfranceschi, Franco; Cassetta, Laura; Masera, Filippo; Cherubini, Antonio; Corsonello, Andrea and Lattanzio, Fabrizia, et al. (2015) In International Psychogeriatrics 27(9). p.1563-1572
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... (More)

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).

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type
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publication status
published
keywords
Alzheimer's disease, caregiver, community-living, cost analysis, RCT, UP-TECH
in
International Psychogeriatrics
volume
27
issue
9
pages
10 pages
publisher
Cambridge University Press
external identifiers
  • scopus:84938419659
ISSN
1041-6102
DOI
10.1017/S104161021500040X
language
English
LU publication?
no
id
08e4d74c-54ef-45eb-ac2e-c45d7253166b
date added to LUP
2017-03-16 11:56:17
date last changed
2017-06-01 11:07:56
@article{08e4d74c-54ef-45eb-ac2e-c45d7253166b,
  abstract     = {<p>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).</p>},
  author       = {Chiatti, Carlos and Furneri, Gianluca and Rimland, Joseph M and Demma, Federica and Bonfranceschi, Franco and Cassetta, Laura and Masera, Filippo and Cherubini, Antonio and Corsonello, Andrea and Lattanzio, Fabrizia and Baldassarri, Diletta and Bitti, Luigina and Carosi, Aurora and Sabbatini, Maila and Paolasini, Elisabetta and Fiori, Tania and Fronzi, Cinzia and Giacchetta, Simona and Giacomini, Valeria and Giovagnoli, Laura and Lattanzi, Giuli and Manca, Anna Maria and Marinelli, Ida and Pigini, Valeria and Pignotti, Marina and Proietti, Maria Chiara and Quarticelli, Antonia and Rovedi, Martina and Tasso, Letizia and Valeri, Valentina and Antonioli, Andrea and Barabucci, Mariella and Bassani, Mara and Bollettini, Paola and Bruttapasta, M. Cristina and Buccolini, Carla and Carangella, Rosa and Carboni, Franca and Ceccolini, Daniela and D'Incecco, Patrizia and Di Felice, Mariangela and Dini, Lara and Gioia, Giordano and Di Prima, Giuseppe and Giusepponi, Giancarlo and Lanciotti, Cesarina and Loffreda, Alessia and Luciani, Oriana and Mariani, Laura and Mastrorilli, Francesco and Moroni, Roberto and Piatkowska, Izabela and Rucoli, Roberta and Scoccia, Giampaola and Teodori, Nives and Tonelli, Tiziana and Angeloni, Rossano and Bratti, Rosa Anna and Bonafede, Giuseppe and Lorenzetti, Severino and Paci, Cristina and Picciotti, Giovanna and Pezzola, Donella and Rea, Vincenzo and Scialè, Vittorio and Signorino, Mario and Sorvillo, Francesca and Tomassini, Pia Francesca and Ciccola, Alessia and Cionfrini, Loena and Alessandrini, Daniela and De Santis, Antonio and Formica, Brunetta and Tacchi, Giuliano and Tortorelli, Silvia and Marchegiani, Gemma and Pozzari, Giovanni and Santarelli, Giovanni and Bartolucci, Dario and Caraffa, Giorgio and Cavallo, Filippo and Di Furia, Lucia and Lacetera, Antonio and Maffei, Claudio M. and Manzoli, Lamberto and Postacchini, Demetrio and Bevilacqua, Roberta and Bonfigli, Anna Rita and Bustacchini, Silvia and Capasso, Marina and Civerchia, Patrizia and Di Rosa, Mirko and Giuli, Cinzia and Marcellini, Marzio and Marinelli, Paolo and Melchiorre, Maria Gabriella and Moraca, Maria Elena and Principi, Andrea and Rocchetti, Cristina and Spazzafumo, Liana and Vincitorio, Daniela and Bartulewicz, Krystian and Olivetti, Paolo and Rossi, Lorena},
  issn         = {1041-6102},
  keyword      = {Alzheimer's disease,caregiver,community-living,cost analysis,RCT,UP-TECH},
  language     = {eng},
  month        = {01},
  number       = {9},
  pages        = {1563--1572},
  publisher    = {Cambridge University Press},
  series       = {International Psychogeriatrics},
  title        = {The economic impact of moderate stage Alzheimer's disease in Italy : Evidence from the UP-TECH randomized trial},
  url          = {http://dx.doi.org/10.1017/S104161021500040X},
  volume       = {27},
  year         = {2015},
}