OBJECTIVES: A comprehensive review was conducted to report evidence from published studies evaluating the economic burden of autism and ASD in both children and adults in European Union (EU5) countries.

METHODS: A systematic search of literature databases (Embase and MEDLINE) was conducted to identify recent economic evidence for last 5 years (Jan-2011 to Mar-2017) on ASD in the EU5 (UK, Germany, Italy, Spain and France). All studies reporting cost burden of ASD in English were included, regardless of design and interventions. Two reviewers assessed trial eligibility, with discrepancies reconciled by a third independent reviewer.

RESULTS: Of the 5,223 citations retrieved, 13 met the pre-defined inclusion criteria. For the UK, total costs for children with ASD were £500 per month. The largest cost components for children were special education services and parental productivity loss. The estimated number of ASD prescriptions per 10,000 children was the highest in Spain (100), followed by the UK (63) and Germany (11). Annual costs for children in the UK increased with age (2–3 years: £6,815; 4–17 years: £29,767; ≥18 years: £49,804). The cost of supporting an individual in the UK with an ASD and intellectual disability during his or her lifespan was £1.5 million, compared to £0.9 million for an individual with ASD without intellectual disability. During adulthood, residential care or supportive living accommodation contributed the highest costs. Respite care was used by a fifth of adolescents with ASD in UK. In one Spanish study, 1.5% of total hospitalisation in 2014 was reported as relating to ASD.

CONCLUSIONS: The economic burden of ASD in Europe is substantial. Further research is needed to evaluate the financial burden on families caring for patients with ASD, which can help to ensure that adequate resources are in place to reduce the barriers to care for this population.