In 2008, the economic burden of dementia in the United Kingdom (UK) was estimated at £23 billion a year. This was more than cancer and coronary heart disease (CHD) combined and includes costs to not only the healthcare system, but to patients, to family and friends who provide unpaid care, and to the wider economy and society.
Cost of illness studies provide a potentially useful decision making aid for setting priorities in healthcare research. In 2008, dementia had the highest economic burden but received a disproportionately low share of government and charity research spending. Indeed, when compared with cancer, CHD and stroke, dementia accounted for over half of the combined health and social care costs of these four conditions and received only 6% of combined research funding. In 2012, although the proportion of research spending for dementia had increased, overall funding remained low.
This study aims to provide an up-to-date estimate (using 2018 data) for the economic costs of dementia, cancer, CHD and stroke in the UK. Statistical models will be developed to predict counts of visits to primary and to secondary care in 2018, from which marginal effects associated with each of the four conditions will be obtained. The results from these models will be compared with those of the 2008 study to understand how the economic burden of these four conditions has changed over the last ten years. The findings of this comparison will help guide future research and investment priorities for the NHS.
In 2008, the economic burden of dementia to society was estimated as £23 billion a year, more than the costs of CHD and cancer, combined. This estimate considered the significant economic burden on informal caregivers (unpaid friends and relatives) as well as the productivity losses associated with working-age patients who are unable to work after dementia onset.
This study will provide an estimate of the economic burden of dementia care in the UK in 2018 and compare it with CHD, stroke and cancer. CALIBER open access resource was used to derive the CPRD Aurum codes for each of the four conditions in order to obtain data on visits to primary and secondary care attributable to each of these conditions. Visits to primary and to secondary care for each of these four conditions will be modelled to estimate the amount of resources consumed. The degree to which the resource use for each condition has changed over the last ten years will also be determined using the data from previously published work (1) (2).
A prevalence-based approach for the year 2018 will measure all costs, regardless of disease onset time. Data from the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) will be used to estimate the healthcare resources used – primary care, inpatient, outpatient and accident and emergency (A&E) contacts - and costs incurred by people with any of the four conditions of interest. Office for National Statistics (ONS) mortality data linked to CPRD will be used to capture those who died in the community before accessing medical care. In separate analyses, national data from Department for Work and Pensions and ONS will inform lost earnings due to incapacity and mortality. The conclusions of this study will be used to guide future decisions about health care research funding allocation.
Health Outcomes to be Measured:
1. Total economic burden of dementia, CHD, stroke and cancer care in 2018 in the UK (specifically, health, social care, and other costs associated with productivity losses and informal care costs).
2. Total research funding allocated to each of dementia, CHD, stroke and cancer in 2018 in the UK.
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation