OBJECTIVES: Alzheimer’s disease (AD) has a significant impact on the quality of life of both patients with AD and their caregivers. High direct and indirect costs are associated with the diagnosis and management of AD. This study aimed to understand costs from the US; UK, France, Germany, Italy, and Spain (EU-5) to estimate the economic impact on various healthcare systems.

METHODS: A systematic search of the literature was conducted via PubMed through November 2019 to identify the studies assessing the cost of illness of AD in the US and EU-5. Direct costs (DC) from the utilization of healthcare resources and indirect costs (IC) from non-medical sources or caregiver involvement for the management of AD were extracted by country from included studies. The average annual costs per patient were calculated by inflating reported costs to 2020 US dollars. IC were compared to DC within and across countries.

RESULTS: After screening 356 articles, 25 studies were included in this review. Data were extracted from eight studies on the US and France, three on Spain and the UK, two on Germany, and a single study on Italy. There were differences in types of costs included for DC and IC across studies. The difference between costs were highest in Spain; with IC almost 10 times higher than DC. The average IC were lower than DC in Germany. Highest IC were estimated for Spain ($58,000), while the highest DC were estimated for Germany ($23,000).

CONCLUSIONS: Based on the average annual costs per patient, IC was observed to be higher than DC in most countries. The high variance in costs between countries showcases the disparity in AD management in different healthcare systems. IC associated with the care of patients with AD cannot be neglected when assessing the cost of illness and the ensuing burden on the healthcare systems.