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Economic Costs of Autism. Martin Knapp London School of Economics & King’s College London (IoP) Based on research conducted with Renee Romeo & Jennifer Beecham. Our over-riding concern is how to meet personal & family needs … So why is economics relevant?
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Economic Costs of Autism Martin Knapp London School of Economics & King’s College London (IoP) Based on research conducted with Renee Romeo & Jennifer Beecham
Our over-riding concern is how to meet personal & family needs … So why is economics relevant? Scarcity never enough resources to meet all of society’s needs or wants. So … economists are asked to look carefully at: • costs • cost-effectiveness • how to improve resource allocation Why? Today’s focus
Prevalence • Level of functioning • Place of residence • Service use patterns • Family expenses • Lost employment • Costs per person • UK-wide costs • Lifetime costs Methods
Many different prevalence estimates, growing over time … Could be due to: • Better recognition of needs? • More accurate diagnosis? • Or underlying growth in prevalence? Most recent study is by Gillian Baird et al (Lancet 2006) in SE England of children aged 9-10 We have assumed prevalence of 1% of total UK population have ASD Prevalence
The autism spectrum contains a number of different conditions or needs … … with different behavioural characteristics, … and different implications for support from families, formal services etc … and hence (probably) different costs We were hampered by lack of data and we have simply distinguished: • low-functioning ASD (IQ<70) • high-functioning ASD (IQ>70) From Gillian Baird’s study we assumed: • 55% of people with ASD are low-functioning • 45% are high-functioning Functioning
Where do people with ASD live? Again – very difficult to find any national or even local data … so estimates made from various sources (NAS, Emerson report on people with ID, Bebbington & Beecham on Children in Need …) Children: • All high-functioning children live in private households • 2% of low-functioning children are in residential care or foster placements Residence
What services and supports do people with ASD receive? We got data from: • Our own previous studies of people with intellectual disability – looking at those with ASD – mostly from England • Jeni Beecham’s work on Children in Need data for England • The ONS survey of mental health problems (children) 2004, Great Britain • A Scottish study by Anna Cooper et al • A Swedish study of HF ASD people We re-grouped and inflated these data to fit residence categories and cover UK Services
In addition we looked atfamily costs: • Out-of-pocket payments for services or treatments • Time spent on informal care … but could not find any data • Lost income because of disrupted employment (= lost productivity) And we also looked at: • Lost productivity for people with ASD who were not in employment And we estimated social security benefits received – but these might ‘double-count’ some other costs Other costs
Costs of ASD – UK - 2005/06 Children – annual cost in the UK Low-functioning ASD = £1,727 mill. High-functioning ASD = £991 mill. Adults – annual cost in the UK Low-functioning ASD = £16,907 mill. High-functioning ASD = £8,573 mill.
Overall UK cost of ASD Aggregate cost – for children and adults - for high-functioning and low functioning autism: £28 billion
Lifetime cost of ASD Someone with low-functioning ASD =£4.7 million Someone with high-functioning ASD = £2.9 million
Huge overall economic impact • Costs are widely spread across different budgets and parts of government – need coordination • High costs fall to families – Is this fair? Is it sustainable? • High costs associated with lost employment: Can we do better to support people into jobs? • High costs of supporting adults with ASD can we reduce them by offering better and earlier intervention? And so …?
