Economic impact of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorder (FASD): Systematic review

In brief

Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorder (FASD) have serious public health, social, and economic impacts. Individuals with FASD often have health issues and special needs that require ongoing support. When support is not available, these individuals may face challenges related to mental and physical health, addiction, education, employment, and involvement with the justice system. These challenges heavily impact both the individual and society.

Researchers at the Centre for Addiction and Mental Health recently conducted a systematic review of studies on the economic impact of FAS/FASD. EENet has developed a Research Report Round-up of their report, Economic Impact of Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorder (FASD): Systematic Review.

Research Report Round-ups are brief summaries of research reports, presented in a user-friendly format.

Read it below or download the PDF.

Title and link to report: Economic Impact of Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorder (FASD): Systematic Review

Authors: Svetlana Popova, Brenda Slade, Shannon Lange, Dennis Bekmuradov, Jürgen Rehm – Centre for Addiction and Mental Health, Social and Epidemiological Research Department

Year: 2012

Location: Ontario
Type of study: Systematic literature review
KeywordsFetal alcohol syndrome, fetal alcohol spectrum disorder, cost
Language of report: English

What this report is about

FASD has serious public health, social, and economic impacts. Individuals with FASD often have health issues and special needs that require ongoing support. When support is not available, these individuals may face challenges related to mental and physical health, addiction, education, employment, and involvement with the justice system. These challenges heavily impact both the individual and society. It’s important to estimate the cost of this impact, to evaluate available programs and inform policy.

The authors conducted a systematic review of published studies in the world literature concerning the economic impact of FAS/FASD using multiple electronic databases. They found 13 well-documented cost studies; three in Canada and 10 in the United States. They did not find any comprehensive FASD cost studies for any other countries.

The economic estimates show that FASD is an important public health issue. The authors describe the various methods used in these studies and discuss the strengths, limitations, and gaps in the studies’ methods.

Some of the findings are as follows:

  • In Canada, the annual cost associated with FASD is about $5.3 billion (CND) and the life-time cost per person with FASD is $1.12 million (CND).
  • Canadian cost estimates included direct healthcare costs, other direct costs (education and social services), indirect costs (lost productivity costs), and out of pocket costs.

Two types of studies were conducted in the US: those estimating the total cost of the FAS nationally and those estimating lifetime cost for individuals.

US studies only included costs related to FAS and did not assess the costs associated with the other FASD diagnoses.

US studies estimated the annual costs to be between $1.6 million (USD) and $8.5 billion (USD), and the individual lifetime cost at either $1.6 million (USD) or $2.5 million (USD).

Variations in the cost estimates in the US studies may be the result of using different prevalence rates, age ranges, cost components, co-morbidities, rates of service use, cost of services, as well as increases in the knowledge base and inflation rates.

It is difficult to estimate the total cost of FAS/FASD because the cost components are derived from multiple services and appropriate data may not be available. Current Canadian cost estimates do not include the cost of children in care, research, and prevention. Similarly, US cost estimates typically exclude the costs of medical services for physical problems, special education, welfare payments to family, substance abuse services, mental health and vocational services, services for learning disabilities, and lost productivity.

Estimates from Canada and US don’t account for all the costs related to law enforcement.

Overall, there is a need for more research to understand the economic impact of FAS/FASD in Canada and other countries, as well as the development of a comprehensive cost estimate. Such cost estimates should include all FASD-related diagnoses and all necessary cost components.

How can this report be used

The information in this literature review will be used to inform the next stage of this project. Dr. Popova and her team are conducting a comprehensive study on the estimation of the economic impact of FASD in Canada (2012-2014). This study is trying to overcome the limitations of the previous cost studies and provide Canadian policymakers with the most comprehensive estimates of the cost associated with FASD.

Contact person/source: Dr. Svetlana Popova, lana [dot] popova [at] camh [dot] ca

Related literature

Popova, S., Lange, S., Burd, L., & Rehm, J. (2013). Canadian children and youth in care: The cost of Fetal Alcohol Spectrum Disorder. Child and Youth Care Forum. DOI 10.1007/s10566-013-9226-x. Available from http://link.springer.com/article/10.1007%2Fs10566-013-9226-x

Popova, S., Lange, S., Burd, L., Chudley, A., Clarren, S., & Rehm, J. (2013). Cost of Fetal Alcohol Spectrum Disorder diagnosis in Canada. PLoS ONE 8(4): e60434. DOI:10.1371/journal.pone.0060434. Available from http://www.plosone.org/article/fetchObject.action?uri=info%3Adoi%2F10.13...

Popova, S., Lange, S., Burd, L., Urbanoski, K., & Rehm, J. (2013). Cost of specialized addiction treatment of clients with Fetal Alcohol Spectrum Disorder in Canada. BioMed Central Public Health, 13, 570.Available from: http://www.biomedcentral.com/content/pdf/1471-2458-13-570.pdf

Popova, S., Lange, S., Burd, L., & Rehm, J. (2012). Health care burden and cost associated with Fetal Alcohol Syndrome in Canada: Based on official Canadian data. PLoS ONE, 7(8), e43024. doi:10.1371/journal.pone.0043024.t004. Available from http://www.plosone.org/article/fetchObject.action?uri=info%3Adoi%2F10.13...

Popova, S., Stade, B., Lange, S., & Rehm, J. (2012). A model for estimating the economic impact of Fetal Alcohol Spectrum Disorder. Journal of Population Therapeutics and Clinical Pharmacology, Incorporating Fetal Alcohol Research, 19(1), e51-e65. Available from http://www.jptcp.com/pubmed.php?articleId=357

Popova, S., Stade, B., Lange, S., Bekmuradov, D., Mihic, A., & Rehm, J. (2012). Methodology for estimating the economic impact of Fetal Alcohol Spectrum Disorder, ISBN: 978-1-77052-990-8. Toronto, Canada: Centre for Addiction and Mental Health. Available in English from https://knowledgex.camh.net/reports/Documents/Popova_etalMethodologySumm...

Popova, S., Stade, B., Lange, S., Bekmuradov, D., Mihic, A. et Rehm, J. (2012). Méthode d’estimation des répercussions économiques de l’ensemble des troubles causés par l’alcoolisation fœtale, ISBN: 978-1-77052-999-1. Toronto, Canada: Centre de toxicomanie et de santé mentale. Available from https://knowledgex.camh.net/reports/Documents/Popova_etalMethodologySumm...

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