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Saturday, April 13, 2019

Economic Costs of Autism

In The Politics of Autism, I discuss costs and benefits of autism services.

Nicky Rogge and Juliette Janssen have an article at Journal of Autism and Developmental Disorders titled The Economic Costs of Autism Spectrum Disorder: A Literature Review

The abstract:
Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.
From the article:
Based on the studies reviewed, the overall lifetime costs for individuals with ASD are estimated to be situated somewhere between $ 2.4 million (in 2011 US$) (Buescher et al. 2014) to $ 3.2 million (in 2003 US$) (Ganz 2007) for the US and from £ 1.5 million (in 2011 £) (Buescher et al. 2014) to £ 2.4 million (in 1997–1998 £) (Järbrink and Knapp 2001) for the UK. As a total figure for the US, Leigh and Du (2015) estimated annual direct medical, direct non-medical, and productivity costs combined to be $268 billion (range $162–$367 billion; 0.884–2.009% of GDP) for 2015 and forecast this cost to be $461 billion (range $276–$1011 billion; 0.982–3.600% of GDP) for 2025. Moreover, as pointed out by some studies, reported cost estimation figures are likely to underestimate true ASD-related costs due to omitted health impacts, omitted economic impacts, omitted impact on social life, and the costs of health actions in other sectors.
[T]he cost of (special) education, EIBI and therapy, individual productivity loss, parental productivity loss, and (supported) accommodation and residential care are among the largest contributors to total lifetime costs for an individual with ASD. The recent anonymous online survey for children and adults with ASD organized across multiple EU-countries in a large-scale project (ASDEU 2018), found similar results, with the cost of special education services being the highest cost component, followed by the costs of tutorial support, especially among younger people with ASD. Medical and healthcare costs related to ASD have been found to constitute only a small part of the total costs for individuals with ASD, with medical costs being higher for adults with ASD than for children with ASD. Estimates also show that smaller out-of-pocket expenses related to ASD, such as travel costs, cost related to making the house more ASD-friendly, purchase of specialised tools or equipment, etc., cannot be ignored when analysing the costs related to ASD. Summed together, all these out-of-pocket expenses can place a significant financial burden on the family budget. As to the costs of ASD-related therapies, due to the differences in therapy categorization and widely divergent cost estimates for ASD therapies, it is difficult to get a clear picture of the costs of therapy and/or EIBI programmes for individuals with ASD. Nevertheless, the studies that assessed the cost-effectiveness of EIBI for (young) children with ASD found that such therapy programmes are cost-effective and can result in cost savings throughout the lifetime of individuals with ASD.