Regional/National cost of illness estimates
Cost of dementia
by Anders Wimo, MD, PhD, professor, Karolinska Institutet, Linus Jönsson, PhD, I3 Innovus and Anders Gustavsson, Senior Analyst, I3 Innovus
There are regional patterns in Europe with a dominance for direct costs (mainly institutional care) in Northern Europe while informal care is the major costs component in Southern Europe (table 4).
Table 4. Regional COI-patterns in Europe (billions €) in 2008.
| European Regions | Direct costs | Informal care | Total costs |
| Northern Europé | 35.8 | 17.3 | 53.0 |
| Western Europé | 27.2 | 25.3 | 52.6 |
| Southern Europé | 11.3 | 46.2 | 57.4 |
| Eastern E urope | 6.3 | 7.8 | 14.2 |
| Europe (including Turkey) | 80.6 | 96.6 | 177.2 |
The cost per demented person was about 22,000 € per year (table 5), while it was somewhat lower for the wider EU sphere and for the whole of Europe. The total societal costs per case are estimated to be 8 times more in Northern Europe than in Eastern Europe.
Table 5. Annual cost per demented in Europe (€) in 2008 for Alzheimer´s disease and other dementias.
| Direct costs | Informal care | Total costs |
|
| EU 27 | 9,925 | 12,270 | 22,194 |
| EU27 + candidate countries , EEA countries and Switzerland | 9,754 | 11,672 | 21,426 |
| Europe (including Turkey) | 7,971 | 9,556 | 17,526 |
Table 6. Annual regional cost per demented in Europe (€) in 2008.
| European Regions | Direct costs | Informal care | Total costs |
| Northern Europé | 24,276 | 11,711 | 35,987 |
| Western Europé | 9,400 | 8,749 | 18,149 |
| Southern Europé | 4,380 | 17,963 | 22,343 |
| Eastern E urope | 1,998 | 2,475 | 4,473 |
| Europe (including Turkey) | 7,971 | 9,556 | 17,526 |
The country specific COI data and cost per case data are seen in tables 7 and 8.
Table 7. Cost of illness of dementia in Europan countries (millions €) in 2008.
| COI direct | COI informal care | COI all |
||
| Northern Europé | Denmark | 882,8 | 564,9 | 1447,7 |
| Estonia | 37,9 | 46,9 | 84,8 |
|
| Finland | 1513,0 | 609,2 | 2122,2 |
|
| Iceland | 81,3 | 32,7 | 114,0 |
|
| Ireland | 282,0 | 277,5 | 559,5 |
|
| Latvia | 63,8 | 79,1 | 142,9 |
|
| Lithuania | 107,3 | 132,8 | 240,1 |
|
| Norway | 2267,0 | 912,7 | 3179,7 |
|
| Sweden | 5608,7 | 578,1 | 6186,8 |
|
| UK | 24925,7 | 14020,7 | 38946,3 |
|
| Western Europé | Austria | 1428,2 | 1076,8 | 2505,0 |
| Belgium | 2193,1 | 201,2 | 2394,2 |
|
| France | 9574,3 | 14685,3 | 24259,6 |
|
| Germany | 10107,6 | 6463,1 | 16570,7 |
|
| Liechtenstein | 4,0 | 3,0 | 7,0 |
|
| Luxembourg | 142,0 | 107,1 | 249,1 |
|
| Switzerland | 1440,6 | 1086,2 | 2526,8 |
|
| The Netherlands | 2336,5 | 1717,4 | 4053,9 |
|
| Southern Europé | Albania | 12,0 | 14,9 | 27,0 |
| Bosnia and Herzegovina | 30,8 | 38,2 | 69,0 |
|
| Croatia | 100,1 | 124,0 | 224,1 |
|
| Cyprus | 47,1 | 186,0 | 233,0 |
|
| Greece | 962,7 | 3802,6 | 4765,4 |
|
| Italy | 4759,1 | 24985,4 | 29744,5 |
|
| Maltas | 17,4 | 68,7 | 86,1 |
|
| Portugal | 343,9 | 2123,8 | 2467,7 |
|
| Serbia and Montenegro | 154,2 | 191,0 | 345,2 |
|
| Slovenia | 74,7 | 92,6 | 167,3 |
|
| Spain | 4119,0 | 14130,7 | 18249,7 |
|
| TFYR Macedonia | 17,1 | 21,2 | 38,2 |
|
| Turkey | 621,4 | 395,8 | 1017,2 |
|
| Eastern E urope | Belarus | 184,2 | 228,2 | 412,4 |
| Bulgaria | 144,2 | 178,6 | 322,8 |
|
| Czech republic | 450,6 | 558,0 | 1008,7 |
|
| Hungary | 415,1 | 514,1 | 929,2 |
|
| Poland | 756,5 | 936,9 | 1693,4 |
|
| Republic of Moldavia | 15,0 | 18,6 | 33,6 |
|
| Romania | 270,5 | 334,9 | 605,4 |
|
| Russian federation | 3255,5 | 4031,7 | 7287,2 |
|
| Slovakia | 142,7 | 176,7 | 319,4 |
|
| Ukraine | 701,8 | 869,1 | 1570,9 |
|
| Europe (including Turkey) | 80591,5 | 96616,3 | 177207,8 |
Table 8 . Annual cost per demented in Europe (€ ) in 2008. Country specific data.
| per case direct | per case informal | per case total |
||
| Northern Europé | Denmark | 11,193 | 7,163 | 18,356 |
| Estonia | 2,588 | 3,205 | 5,793 |
|
| Finland | 19,484 | 7,844 | 27,328 |
|
| Iceland | 24,833 | 9,998 | 34,831 |
|
| Ireland | 7,008 | 6,896 | 13,903 |
|
| Latvia | 2,416 | 2,992 | 5,408 |
|
| Lithuania | 2,548 | 3,155 | 5,703 |
|
| Norway | 30,711 | 12,364 | 43,075 |
|
| Sweden | 33,981 | 3,502 | 37,483 |
|
| UK | 26,200 | 14,738 | 40,938 |
|
| Western Europé | Austria | 12,422 | 9,365 | 21,787 |
| Belgium | 13,627 | 1,250 | 14,877 |
|
| France | 9,914 | 15,206 | 25,119 |
|
| Germany | 7,674 | 4,907 | 12,582 |
|
| Liechtenstein | 12,422 | 9,365 | 21,787 |
|
| Luxembourg | 25,440 | 19,180 | 44,620 |
|
| Switzerland | 12,662 | 9,547 | 22,209 |
|
| The Netherlands | 10,719 | 7,879 | 18,598 |
|
| Southern Europé | Albania | 0,760 | 0,942 | 1,702 |
| Bosnia and Herzegovina | 0,909 | 1,125 | 2,034 |
|
| Croatia | 1,910 | 2,366 | 4,277 |
|
| Cyprus | 5,073 | 20,036 | 25,108 |
|
| Greece | 5,466 | 21,591 | 27,058 |
|
| Italy | 4,591 | 24,100 | 28,691 |
|
| Maltas | 4,185 | 16,528 | 20,713 |
|
| Portugal | 2,498 | 15,424 | 17,922 |
|
| Serbia and Montenegro | 1,484 | 1,838 | 3,323 |
|
| Slovenia | 3,165 | 3,919 | 7,084 |
|
| Spain | 6,234 | 21,387 | 27,622 |
|
| TFYR Macedonia | 1,067 | 1,322 | 2,390 |
|
| Turkey | 2,070 | 1,318 | 3,388 |
|
| Eastern E urope | Belarus | 1,686 | 2,089 | 3,775 |
| Bulgaria | 1,501 | 1,859 | 3,359 |
|
| Czech republic | 3,761 | 4,658 | 8,419 |
|
| Hungary | 3,460 | 4,285 | 7,745 |
|
| Poland | 1,935 | 2,396 | 4,331 |
|
| Republic of Moldavia | 0,464 | 0,575 | 1,039 |
|
| Romania | 1,229 | 1,523 | 2,752 |
|
| Russian federation | 2,250 | 2,786 | 5,036 |
|
| Slovakia | 2,778 | 3,440 | 6,219 |
|
| Ukraine | 1,202 | 1,489 | 2,691 |
|
| Europe (including Turkey) | 7,971 | 9,556 | 17,526 |
When the burden of dementia disorders in terms of DALYs is compared to diabetes, the burden figures are higher for dementia (Table 9).
Table 9. Burden in terms of DALYs in Europe for Alzheimer´s disease and other dementias and Diabetes.
| DALYSx1000 | DALYS per 100000 persons |
|||
| AD and other dementias | Diabetes | AD and other dementias | Diabetes |
|
| EU 27 | 2121 | 1288 | 441 | 268 |
| EU27 + candidate countries , EEA countries and Switzerland | 2227 | 1452 | 398 | 260 |
| Europe | 2799 | 1973 | 350 | 247 |
The regional burden figures (table 10) show that the greatest burden occur in Western Europe.
Table 10. Regional burden of Alzheimer´s disease and other dementias in terms of DALYs
| European Regions | DALYsx1000 | DALYs per 100000 people | DALYs per 1000 AD/demented |
| Northern Europé | 437 | 462 | 355 |
| Western Europé | 867 | 470 | 348 |
| Southern Europé | 769 | 356 | 357 |
| Eastern E urope | 726 | 239 | 282 |
| Europe (including Turkey) | 2,799 | 350 | 331 |
The country specific burden figures reflect the regional differences, but show a rather great range even in the figures per 1000 demented (range 187-471).
Table 11. Country burden of Alzheimer´s disease and other dementias in terms of DALYs
|
|
| DALYsx1000 | DALYs per 100000 people | DALYs per 1000 AD/demented |
| Northern Europé | Denmark | 25 | 471 | 376 |
| Estonia | 4 | 292 | 260 |
|
| Finland | 30 | 580 | 471 |
|
| Iceland | 1 | 382 | 414 |
|
| Ireland | 13 | 333 | 376 |
|
| Latvia | 6 | 268 | 234 |
|
| Lithuania | 8 | 229 | 233 |
|
| Norway | 21 | 464 | 360 |
|
| Sweden | 52 | 581 | 387 |
|
| UK | 276 | 467 | 348 |
|
| Western Europé | Austria | 34 | 410 | 323 |
| Belgium | 56 | 555 | 415 |
|
| France | 289 | 482 | 348 |
|
| Germany | 378 | 459 | 332 |
|
| Liechtenstein | NA | NA | NA |
|
| Luxembourg | 2 | 398 | 401 |
|
| Switzerland | 37 | 497 | 391 |
|
| The Netherlands | 71 | 445 | 396 |
|
| Southern Europé | Albania | 4 | 135 | 268 |
| Bosnia and Herzegovina | 8 | 187 | 303 |
|
| Croatia | 18 | 409 | 376 |
|
| Cyprus | 1 | 165 | 187 |
|
| Greece | 50 | 471 | 367 |
|
| Italy | 304 | 536 | 339 |
|
| Maltas | 1 | 339 | 384 |
|
| Portugal | 43 | 439 | 382 |
|
| Serbia and Montenegro | 26 | 240 | 282 |
|
| Slovenia | 7 | 378 | 358 |
|
| Spain | 217 | 550 | 382 |
|
| TFYR Macedonia | 4 | 191 | 300 |
|
| Turkey | 84 | 117 | 392 |
|
| Eastern E urope | Belarus | 24 | 239 | 283 |
| Bulgaria | 22 | 281 | 264 |
|
| Czech republic | 39 | 382 | 385 |
|
| Hungary | 28 | 282 | 265 |
|
| Poland | 96 | 246 | 279 |
|
| Republic of Moldavia | 7 | 171 | 310 |
|
| Romania | 55 | 250 | 290 |
|
| Russian federation | 322 | 221 | 279 |
|
| Slovakia | 12 | 228 | 288 |
|
| Ukraine | 120 | 242 | 269 |
|
| Europe | (including Turkey) | 2 799 | 350 | 331 |
Last Updated: Tuesday 27 October 2009
