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Module 7: Costs of Fetal Alcohol Spectrum Disorders

Annual Costs of FAS

Four sets of investigators have done well-documented studies to estimate the annual cost of FAS in the United States. These studies have detailed and rigorous approaches to cost estimation. They identify costs by category, such as health care costs, residential and support services, special education, and productivity losses.

Cost estimates ranged from $75 million in 19843 to $4 billion in 1998.4 Annual costs vary greatly because different prevalence rates and cost components were used, the knowledge base for developing estimates rapidly increased over time, and a major amount of inflation occurred. Five major factors account for the differences in annual cost estimates:

Three investigators sitting down, discussing results of research studies related to annual costs of FAS
  • Prevalence rates significantly affect overall costs. Cost estimates based on low prevalence rates, such as 0.33 per 1,000,3 will be about 6 times lower than estimates based on prevalence rates of 2 per 1,000.4
  • Differences in medical care and residential services included, the rate of use of such services by individuals with FAS, and the cost of such services all greatly affect estimated costs. For example, residential and support services for individuals with FAS and mental retardation to age 65 add a great deal more costs than studies that estimate such costs only to age 21.
  • Inflation accounts for differences between estimates for various years.
  • The knowledge base for developing cost estimates has rapidly increased over time. Thus, more weight should be given to the more recent estimates, since they have learned from and built on prior estimates.
  • Estimates that include the cost of lost productivity typically will exceed estimates that exclude it.

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