Objectives: To examine the economic burden (direct and indirect costs) of Alzheimer disease (AD) and to analyze the impact on health-related quality of life (HRQOL) for patients with AD and caregivers in 2001 in the Canary Islands, Spain.
Methods: Two hundred thirty-seven patients (61% of those contacted) were recruited from the Alzheimer's Disease Association in the Canary Islands. Demographic, health resources utilization, informal care, indirect costs, and quality of life data were collected from primary caregivers of patients as proxy respondents. HRQOL was measured for patients and caregivers with the generic questionnaire EQ-5D.
Results: The average annual cost per patient with AD was 28,198 (36,144 US dollars). The most important categories of costs were for informal care and drugs. Costs increased with cognitive impairment with an average annual cost of 14,956 (19,171 US dollars) for mild, 25,562 (32,765 US dollars) for moderate, and 41,669 (53,411 US dollars) for severe patients. The total cost of patients with AD in Canary Islands was 259 (332 US dollars) million. The HRQOL with the EQ-5D social tariff was 0.29 for patients and 0.67 for caregivers. The EQ-5D VAS (thermometer) score was 42 for patients and 62 for caregivers.
Conclusions: Direct health care costs of AD represented 2.4% of the total public health care expenditure in the Canary Islands. Across all severity levels, we estimated a total annual cost of 10 (13 US dollars) billion for AD patients older than 65 years in Spain. The degree of severity of the patients with AD substantially influenced the quality of life of the patients but not that of the caregivers.