This paper by Gray & Fenn (1993) represents the first systematic attempt to put a cost on Alzheimer's disease (AD) in England. At a time when a large proportion of research effort in AD is directed towards the basic biology, it is an interesting and novel avenue for investigation. There are those who would say it is long overdue. The authors introduce the burden of illness analysis which is essentially a comprehensive attempt to cost the impact of a disorder. The analysis takes into consideration differences in the expression of disease – chronic, non life-threatening disorders rank relatively highly in loss of earning and health service costs but relatively low as a contribution to mortality. A number of concepts are explained which will be of interest to the non-expert, such as the difference between real resource costs, (e.g. payment for a service such as Attendance Allowance to a carer) and transfer payment (e.g. paying Income Support to an AD sufferer). Mortality rates (which give an equal weighting to a death independent of the age at which it occurs) are replaced by potential years of life lost – the loss of economic contribution to society being greater the younger the age of death.
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