The Cost of Raising Individuals with Fragile X or Chromosome 15 Imprinting Disorders in Australia

The economic impact of caregiving for individuals with Angelman syndrome in the United States: results from a caregiver survey

BACKGROUND

Angelman syndrome (AS) is a rare neurogenetic disorder characterized by persistent cognitive and functional impairments that necessitate lifelong care. Caring for individuals with AS leads to substantial household costs, as well as impacts on work productivity, leisure time, and quality of life for caregivers. The economic value of these impacts in the United States (US) has not been well studied. We conducted a survey of US caregivers for persons with AS to quantify the annual economic impact of caregiving. Information on AS-related economic impacts was gathered, including household costs, employment impacts, leisure time loss, and caregiver healthcare costs. The survey did not gather information on direct medical care costs borne by healthcare insurers or other economic impacts to the US government and other stakeholders.

RESULTS

A total of 105 caregivers completed the survey and 105 individuals with AS were represented. Most caregivers were female (89.5%), white (83.8%), and identified as the primary caregiver (75.2%). Most individuals with AS represented in the sample were age < 18 (82.9%). The annual economic impact of caregiving for persons with AS averaged $79,837 (SD $55,505). Costs related to employment impacts and lost work productivity in the past 12 months accounted for most (53%) of this impact and averaged $42,697 (SD $28,309). Household costs incurred in the past 12 months for goods and services to better accommodate individuals with AS were $29,680 (SD $47,753). Leading contributors included vehicle purchases and modifications (mean $6,717; SD $17,791), professional caregiving (mean $6,123; SD $17,335), home modifications and repairs (mean $4,387; SD $15,734), and supportive therapy (mean $3,269; SD $7,564). Economic impacts in the past 12 months from lost leisure time and incremental healthcare costs for caregivers were estimated to be $6,634 (SD $4,652) and $827 (SD $2,072), respectively.

CONCLUSIONS

Caregivers incur substantial costs to accommodate individuals with AS, as well as substantial impacts related to employment and leisure time. This study's findings may be utilized in future research to better estimate the value from therapeutic advances in AS and direct resources toward mitigating economic impacts for households.

The Well-being and Support Needs of Australian Caregivers of Neurodiverse Children

Caregivers of children with neurodiverse needs are known to experience challenges and hardship due to the increased needs of the child and the lack of support available. This study aimed to explore the support needs and well-being of caregivers of children with neurodiverse needs in Australia. Sixty-six caregivers participated in an online survey asking questions about support needs. The results highlighted five main themes that caregivers commonly experienced including: barriers to community engagement, impact on close relationships, negative impact on mental health and identity, financial hardship, and identified support needs. Findings identified multiple unmet needs existing amongst caregivers and further emphasises the importance of addressing these needs to improve the quality of life of caregivers of children with neurodiverse needs.

Are We Capturing the Socioeconomic Burden of Rare Genetic Disease? A Scoping Review of Economic Evaluations and Cost-of-Illness Studies

BACKGROUND AND OBJECTIVES

Rare diseases have a significant impact on patients, families, the health system, and society. Measuring the socioeconomic burden is crucial to valuing interventions for rare diseases. Healthcare system costs are significant, but so are costs to other government sectors, patients, families, and society. To understand the breadth of costs captured in rare disease studies, we examined the cost categories and elements of socioeconomic burden captured in published studies.

METHODS

A scoping review was conducted using five electronic databases to identify English language economic evaluations and cost-of-illness studies of interventions for rare diseases (2011-21). We mapped costs using a previously developed evidence-informed framework of socioeconomic burden costs for rare disease.

RESULTS

Of 4890 studies identified, 48 economic evaluations and 22 cost-of-illness studies were included. While 18/22 cost-of-illness studies utilized a societal perspective, only 7/48 economic evaluations incorporated societal costs. Most reported cost categories related to medical costs, with medication and hospitalizations being the most common elements for both study designs. Costs borne by patients, families, and society were reported less among economic evaluations than cost-of-illness studies. These included: productivity (10% vs 77%), travel/accommodation (6% vs 68%), government benefits (4% vs 18%), and family impacts (0% vs 50%).

CONCLUSIONS

Contrary to cost-of-illness analyses, most of the included economic evaluations did not account for the hidden burden of rare diseases, that is, costs borne by patients, families, and societies. Including these types of costs in future studies would provide a more comprehensive picture of the burden of disease, providing empirical data to inform how we value and make decisions regarding rare disease interventions, health policy, and resource allocation.

Estimating the impact of Angelman syndrome on parental productivity in Australia using productivity-adjusted life years

BACKGROUND

Angelman syndrome (AS) is a rare genetic condition characterized by global developmental delay, including severe intellectual disability. The parents of persons with AS experience increased stress, anxiety, and depression. This impacts parents' career choices and productivity.

OBJECTIVE

To estimate, for the first time, the total productivity lost by the parents of persons with AS over a 10-year period in Australia and the corresponding cost to society.

METHODS

A cost-of-illness model with simulated follow-up over a 10-year period was developed, with 2019 as the baseline year, facilitated by a Markov chain of life tables. The prevalence of persons with AS and their parents, the productivity-adjusted life years (PALYs) lost by parents, and the cost to society were estimated. Key data were obtained from a prospective cohort of AS families, peer-reviewed literature, and publicly available sources.

RESULTS

The base-case productivity burden borne by the estimated 330 living parents of the 428 prevalent persons with AS totaled AUD$45.30 million, corresponding to a loss of 38.42% of PALYs per parent.

CONCLUSIONS

Caring for a child with AS has a significant impact on the productivity of affected parents, with a large associated impact on the broader Australian economy.