dementia 2010 full

7/30/2019 Dementia 2010 Full

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The ecooc bure o eeta a aocate reearch u

the Ute Ko

A report prouce b the Health Ecooc Reearch Cetre,

Uvert o Oxor or the Alheer Reearch Trut

RAmOn LUEngO-FERnAndEz, JOsE LEAL, ALAsTAiR gRAy

www.eeta2010.or

DEMENTIA 2010


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DEMENTIA 2010 full rEporT dementia2010.g

The Alheer Reearch Trut the UK lea reearch chart or

eeta.

We are ecate to u cetc tue to wa to treat, cure or

prevet Alheer eae, vacular eeta, eeta wth Lew Boe

a roto-teporal eeta.

We o ot receve a overet u a tea rel o oato

ro vual, copae a chartable trut, oe rae b

vual a t let people Wll to u our vtal work.

Our retere chart uber 1077089.

F out ore at: www.alheer-reearch.or.uk

Abt the Azheimes reseach Tst


3/38

1

Our thak o to Jae Woltehole or allow u to acce reource ue orato ro a cohort o

eeta patet. We woul lke to ackowlee all thoe charte a overetal oraato who ver

helpull repoe to our requet or orato. Wthout ther help th tu woul ot have bee poble.

We are rateul to the Ela a Wale Chart Coo, epecall Eleaor Tew, or prov u wth a

copreheve lt o all charte potetall u health reearch. The help receve ro the departet

o Health, socal servce a Publc saet o norther irela, a Wale nHs who prove u wth the

ata ue th aal alo rateull ackowlee. Fall our thak o to La sarolou a naok

Akahae or ther atace collat ata or th report.

Ackowleeet

Cotet

Foreword 2

Introduction 3

Key fndings 4

Executive summary 6

Section 1 Introduction 8

Section 2 Methods: Cost o illness study 10

2.1 Introduction 10

2.2 Costs o dementia 11

2.2.1 nuber o eeta cae

the UK 11

2.2.2 socal care 11

2.2.3 Health care 122.2.4 ioral care 12

2.2.5 Prouctvt loe 14

2.3 Costs o cancer 15

2.3.1 socal care 15

2.3.2 Health care 15

2.3.3 ioral care 16

2.3.4 Prouctvt loe 17

Section 3 Methods: Research unding 17

3.1 Introduction 17

3.2 Governmental health

research unding 173.3 Charity health unding 18

Section 4 Results: Costing studies 19

4.1 Costs o dementia 19

4.1.1 Prevalece o eeta the UK 19

4.1.2 socal care cot 19

4.1.3 Health care cot 19

4.1.4 ioral care cot 21

4.1.5 Prouctvt cot 21

4.1.6 setvt aal:

Prevalece rate 21

4.2 Costs o cancer 22

4.2.1 socal care 22

4.2.2 Health care cot 22

4.2.3 ioral care cot 23

4.2.4 Prouctvt cot 23

4.3 Cost comparisons

across diseases 23

Section 5 Results: Research unding 24

5.1 Sample 24

5.1.1 goveretal aece 24

5.1.2 Charte 24

5.2 Levels o research unding 25

Section 6 Discussion 26

Reerences 29

Appendix 1 Charity research unding

proorma 33

Appendix 2 List o included charities 34

Table a Fure

Tables

1. EUROdEm prevalece rate o aoe

a uaoe eeta the UK 11

2. nuber o aoe a uaoe

eeta cae the UK 2006 19

3. Cot o eeta the UK 20

4. setvt aal: hoptalato b

eeta ao 20

5. setvt aal: eeta eath

b caue 21

6. Cot o cacer the UK 22

7. Total cot b eae 23

8. Reao or excluo o charte ete

throuh the Chart Coo 25

9. Reearch u b eae 2007/08 25

10. Reearch u, uber o cae

a total cot o eae 26

Figures

1. Health a ocal care cot 23

2. dtrbuto o cot b eae 24

3. Proporto o reearch u

b eae area 26


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FOREWORd

Dementia costs UK plc 23 billion a yearHow o ou put a prce o le? How o ou eotrate the cot o o oth? Thak to the

Alheer Reearch Trut who cooe th tu we have a awer: 23 bllo care cot a

lot prouctvt.

deeta poe a challee. Challee to cett, challee to

polc-aker, challee to ocet: let uawere cot wll cotue to

re.

O preet tre the UK approach to aa eeta uutaable.

Lea cett have alrea ware that the nHs wll trule to cope

the prevalece o eeta cotue to re.

The goveret eeta trate oer the propect o a better oel o

care. But t oer o awer to the exorable re the ea or care.

The awer ut urel be hua eut a cover. more u are

eee to eable cett to reearch a uerta eeta, to reearch

a evelop ew treatet. yet toa or ever pou pet o eeta care, le tha a quarter o a

pe vete reearch.

The goveret hel a ut o eeta reearch, but ew oe cae there oe. itea, a mteral

takorce o reearch ha bee et up.

A deeta 2010 how eeta rectl afct 820,000 people the UK. yet t touche the lve o o

a ore people. The ecoot a a eeta cot 23 bllo; the true ocal pact calculable.

deeta cot the UK twce a uch a cacer, three te a uch a heart eae a our te a

uch a troke. yet whe t coe to reearch u eeta the poor relato. For ever oe pou

pet o eeta reearch twet x pou are pet o cacer reearch a tee pou o reearch

to heart eae.

deeta 2010 ake clear the cale o the challee; t br eeta to the potlht. The cae or

vetet eeta reearch powerul a clear.

Paul Burstow MP

Lberal deocrat meber o Parlaet or sutto a Chea


2


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3

inTROdUCTiOn

A wake-up call for us alli 2009, the Alheer Reearch Trut cooe the Health Ecooc Reearch Cetre at the

Uvert o Oxor to prouce a report o the ecooc cot o eeta to the UK, a the coutr

vetet reearch to ew treatet, preveto a cure.

The were ake to calculate the care cot o eeta to health

ervce, ocal ervce, upa carer a other, a copare th

to the other reat ecal challee o our ae: cacer, heart eae

a troke. The outta work o Pro Alatar gra, dr Rao

Lueo-Ferae a dr Joe Leal o deeta 2010 ha prouce

portat ew evece.

The Oxor tea are atoh. Ever oe o the 821,884

people the UK wth eeta cot our ecoo 27,647 perear; that ore tha the UK ea alar. B cotrat, patet

wth cacer cot 5,999, troke 4,770 a heart eae 3,455 per

ear. depte th, overet a chartable pe o eeta

reearch 12 te lower tha o cacer reearch. 590 llo

pet o cacer reearch each ear, whle jut 50 llo vete

eeta reearch.

Th houl be a wake-up call or all o u who ca fuece the prort ve to eeta reearch:

overet, charte a the publc a a whole. The Alheer Reearch Trut a to creae t

aual vetet reearch a quckl; wth extra upport ro the publc, we coul o o uch ore. All

three a poltcal parte accept that eeta reearch eerve ore u a a the Pre mter

put t a eet wth the Alheer Reearch Trut that eeta ha bee electe or too lo. We

ow ee to tralate th poltcal etet to overet acto. We welcoe the overet mteral

Avor group o eeta reearch a a pro tart.

i we pe a ore proportoate u o eeta reearch, we coul uleah the ull potetal o our

cett ther race or a cure. spe llo ow reall ca ave u crppl ult-bllo pou care

bll later.

mot portatl, we ut ot oret what thee tattc reall repreet: hure o thoua o

evatate lve, llo o ale a re, calculable potetal quaere.

Wth eouh upport, our cett ca eeat eeta a halt th tal wave o uer.

Rebecca Wood

Che Executve, Alheer Reearch Trut


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4

KEy Findings

821,884 people in the UK live with dementia

deeta cot the UK ecoo 23 bllo per ear. Th ore tha cacer

(12 bllo per ear) a heart eae (8 bllo per ear) cobe.

How the 23 bllo cot o eeta et

25

20

15

10

5

0

deme

ntia

Can

cer

Heart

ieae

strok

e

Unpaid carers 12.4bn

55%

Social care

costs 9bn

40%

Health care

costs 1.2bn

5%

Productivity

losses 29m

0%

billio

ns

Lo ter ttutoal ocal care a oral care cot ake up the ajort o the 23 bllo ure.

mot o the cot o eeta 12.4 bllo per ear et b upa carer. socal care cot are 9 bllo,

health care 1.2 bllo a prouctvt loe 29 llo.



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5

Aual cot () o oe patet

Ever eeta patet cot the ecoo 27,647 per ear: ore tha the UK ea alar (24,700). B

cotrat, patet wth cacer cot 5,999, troke 4,770 a heart eae 3,455 per ear.

Aual overet a chart vetet reearch

goveret a chartable pe o eeta reearch 12 te lower tha o cacer reearch. 590

llo pet o cacer reearch each ear, whle jut 50 llo vete eeta reearch. Heart

eae receve 169 llo per ear a troke reearch 23 llo.

For ever pero wth cacer, 295 pet each ear o reearch. For eeta, that ure jut 61.

30,000

25,000

20,000

15,000

10,000

5,000

0

d

ementia

Canc

er

Heart

ieae

strok

e

140,000

120,000

100,000

80,000

60,000

40,000

20,000

0

ivetet () reearch or ever 1 llo ocal a health care cot

For ever 1 llo care cot or

the eae:

129,269 pet o cacer reearch

73,153 o heart eae reearch8,745 o troke reearch

jut 4,882 o eeta reearch.

Canc

er

dementi

a

Heart

ieae

strok

e


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6

Executve uar

Rationale and objectives

Th report the outcoe o a tu cooeb the Alheer Reearch Trut to etate the

ecooc bure aocate wth eeta to

the UK ecoo or the ear 2008 coparo

wth other ajor eae, a the to copare

the bure o thee eae wth curret level o

reearch u. deeta ecrbe a roup o

pto aocate wth a proreve ecle o

bra ucto, uch a eor, uerta,

jueet, lauae a thk. People wth

eeta are at a creae rk o phcal health

proble a becoe creal epeet o

health a ocal care ervce a other people.

Hece, eeta ha a cat ecooc pact

o the health care te, o patet, o al

a re who prove upa care, a o the

wer ecoo a ocet. The tu reporte

here etate the ecooc bure ro a ocetal

perpectve that clue ot ol health care cot

but alo thoe cot all oute the health care

ector, uch a the opportut cot aocate

wth upa care to patet, or prouctvt loeaocate wth preature eath or abece ro

work ue to eeta. The a wa to copare the

ecooc bure o eeta wth that o cacer,

coroar heart eae (CHd) a troke u the

ae ethoolocal approach. Cacer, CHd a

troke are the three a caue o eath Europe

a the UsA. The UK overet a chart

reearch u wa alo exae or each o

the our coto the acal ear 2007/08.

The a wa to copare the level o UK reearch

u wth the repectve ecooc bure o

eae. it wa expecte that reearch to the

caue, treatet a preveto o a partcular

eae houl be broal relate to t ecooc

bure.

metho

Estimating the economic burden of illness

A prevalece approach wa aopte whereb allcot wth the ot recet ear or whch ata

were avalable were eaure rearle o the ate

o eae oet. A top ow approach wa ue

to etate the total cot u areate ata o

orbt, ortalt, hoptal ao, eae

relate cot, a other health relate cator.

Cot cateore ue clue health care, ocal

care, oral care, a prouctvt loe ue to

preature ortalt a abece ro work.

deeta wa ee a the iteratoal stattcalClacato o deae a Relate Health

Proble 10th Revo (iCd10) F00-F03 a g30,

whch clue Alheer eae, vacular a

upece eeta, a well a eeta other

eae uch a Parko. Cacer wa ee

a iCd-10 coe C00-d48, troke a iCd-10 coe

i60-i69, a coroar heart eae a iCd-10

coe i20-i25.

Reearch uWe ete UK overetal aece that

prove health reearch u a cotacte

the to etere the level o u or

eeta, cacer, CHd a troke the acal

ear 2007/08. Thee aece clue reearch

coucl, uch a the mecal Reearch Coucl

(mRC), a reearch aece ro the departet

o Health a t evolve atrato, uch a

the natoal ittute or Health Reearch (niHR).

Chart oraato that u health reearchwere alo ete ro the Aocato or

mecal Reearch Charte (AmRC) a the Chart

Coo or Ela a Wale. due to the

lare uber o charte the Chart Coo

reter that potetall u health reearch, ol

the top two hure charte ter o ther

aual coe were coere th tu. Thee

two hure charte accoute or over 75% o

the total coe o all reearch u charte.

The level o chart reearch u or each o the

our coto were obtae ro aual report or

rect cotact wth the charte.

The ReportDEMENTIA 2010 full rEporT dementia2010.g


9/38

Reult

Economic burden of illness

The uber o patet wth eeta the UK etate to be 821,884, repreet 1.3% o

the UK populato. We etate that 37% o all

eeta patet the UK are lo-ter care

ttuto cot exce o 9 bllo per ear

ocal care. Health care cot are etate at about

1.2 bllo o whch hoptal patet ta accout

or 44% o the total. ioral care etate to

volve 1.5 bllo hour o upa care prove to

eeta patet lv the cout, whch we

value at 12 bllo. Fall, prouctvt loe ue to

eeta accout or 29 llo. Overall, eeta

ou to cot 23 bllo ter o health a

ocal care, oral care a prouctvt loe

2008.

The cobe health a ocal care cot o

eeta are etate at 10.3 bllo 2008,

copare to 4.5 bllo or cacer, 2.7 bllo

or troke a 2.3 bllo or CHd. U UK

prevalece ata, the health a ocal care cot per

pero wth eae wa etate at 12,521 or

eeta, 2,559 or troke, 2,283 or cacer, a

1,019 or CHd. i ter o ocetal cot, eeta

alo poe the reatet ecooc bure at 23

bllo ollowe b cacer at 12 bllo, CHd at 8

bllo a troke at 5 bllo.

Reearch u

iorato o the level o reearch u or

eeta, cacer, CHd a troke 2007/08

were obtae ro eve o the eht eteoveretal aece. A total o 405 llo

o overetal u wa pet o thee our

eae, o whch 66% wa pet o cacer

reearch ollowe b CHd (21%), eeta (9%)

a troke (4%). A total o 65 charte that prove

reearch u or thee our eae were

ete ro the Chart Coo reter a

the AmRC. Thee charte ha a cobe pe

o 429 llo o cacer, CHd, eeta a

troke reearch. A wth the overetal aece,

ot o thee u were evote to cacer (324

llo, 76%) ollowe b CHd (85 llo, 20%),

eeta (14 llo, 3%) a troke (6 llo,

1%).

i total, the cobe reearch u to

eeta, cacer, CHd a troke b overetal

a chart oraato th tu wa jut

uer 833 llo. O th total, 590 llo (71%)wa evote to cacer, 169 llo (20%) to CHd,

50 llo (6%) to eeta a 23 llo (4%)

to troke. The total level o reearch u per

pero wth the eae were evaluate at 295

per pero wth cacer, 75 per pero wth CHd,

61 per pero wth eeta a 22 per pero

wth troke. Put aother wa, or ever 1 llo

o health a ocal care cot attrbutable to the

eae, cacer receve 129,269 reearch

u, CHd receve 73,153, troke receve

8,745 a all eeta receve 4,882.

A how below, althouh eeta accout

or over 50% o the cobe health a ocal

care cot o the our eae uer tu, t ol

receve 6% o cobe reearch u. i

cotrat, cacer accout or jut over 20% o

health a ocal care cot but receve earl

three quarter o the total ecal reearch u

or thee our eae.

Health a ocal care cot a

reearch u b eae

Conclusions and recommendations

The etate ecooc bure o eeta ar

reater tha cacer, heart eae (CHd) a troke.

depte th, ot reearch u the UK

curretl recte towar cacer. Our aaluet that reearch pe o eeta a

troke everel uerue coparo wth

cacer a CHd.

A Health a ocal care cot

B Reearch u

100%

80%

60%

40%

20%

0%

Canc

er

deme

ntia

Heart

ieae

strok

e

A B B B BA A A

diseaseburen

an

funing

asaproportion

ofthe

total

7


10/38

8

SECTION 1

INTRODUCTION

deeta ecrbe a roup o pto caueb the raual eath o bra cell, lea to

the proreve ecle o ucto uch a

eor, oretato, uerta, jueet,

calculato, lear, lauae a thk [iCd 10

clacato]. deeta a teral eae where

patet are expecte to lve three to e ear ater

ao.1-4 i the Ute Ko (UK), a prevou

tu etate that 683,597 people uere

ro eeta 2005, wth the total orecate

to creae to 940,110 b 2021 a 1,735,087 b

2051.5 The eae occur al oler people,

reerre to a late-oet eeta, but t a alo

occur people uer 65 ear, reerre to a

ou-oet eeta.

There are everal eae that caue eeta.

i late-oet eeta, Alheer eae the

ot coo eae, accout or arou 60%

o all cae, ollowe b cerebrovacular eae

(vacular eeta), a eeta wth Lew boe

whch toether accout or 15-20% o cae. i

ou-oet eeta, roto-teporal eeta

the ot coo eae, ollowe b Alheer.

Le coo eae that a alo caue

eeta clue Parko a Hutto, HiV

a Aids, Korako roe, Creutelt-Jakob

eae, ultple clero, a otor euroe

eae, aot other. Recetl, xe cae

o eeta have alo bee ete uch a

Alheer a eeta wth Lew boe.6

Alheer eae (Ad) a proreve coto

or whch o le caue ha et bee ete,but everal rk actor have bee lke to t, o

whch ae the ot relevat. Ad proreo

ca be ve approxatel to three tae. i

the earl tae, a pero wth Ad experece ver

or chae ther ablte or behavour, e..

hort-ter eor lo, whch a be takel

attrbute to tre or ae. i the le tae,

chae ablt a behavour uch a crea

oretule becoe ore cat, a people

wth Ad requre ore upport to aae ther al

actvte, uch a eat, wah, re or u

the tolet. i the late tae, Ad patet a becoe

creal ral, have cult eat, loe eor

a peech ablte, a o rauall becoe

copletel epeet o other or care. People

wth vacular eeta, uuall ue to a ere o

all troke, experece lar pto a Ad

ato to the pto o troke. However, thepto a evelop uel, rea table or

oe te a the quckl eterorate a the reult

o aother troke, or rauall ecle.

Reao or the appearace o Lew boe the

bra are tll ukow a o rk actor have

et bee ete. deeta wth Lew boe

proreve, althouh wth oe varato

the ablte o the uerer over all pero o

te, a charactere b lar pto to

Parko eae. several eetc utato have

bee aocate wth roto-teporal eeta but

ore tha hal o all cae have o prevou al

htor. People wth roto-teporal eeta wll

experece proreve ecle aocate wth

extree behavoural chae, uch a apath

a euphora, peech a lauae proble,

oveet orer a, at a later tae,

pto lar to thoe Ad whch a requre

ur care.6;7

Few cae o eeta are aoe earl

tae, a a o the aocate pto, e..

eor lo, coul be attrbute to other coto

uch a epreo, abete, thro aboralte,

elru, alcohol or ple ae. Th ake

ao partcularl cult, uch that t a

take up to oe ear or loer or a al ao

to be ae. Foral tet or eeta requre

etal ablt tet, uch a the m metal state

Exaato (mmsE), a revew o ecal htor a

curret ecato, a exaato o bolocal

arker uch a level o aboral proteaocate wth Ad, a oete a ca

uch a aetc reoace a (mRi) ca to

etect chae the bra.

There tll o cot-eectve etho o et

people wth eeta throuh populato cree.6

Earl ao o eeta portat, allow

thoe wth eeta a ther carer to pla better

or ther uture a to tart treatet that a low

eae pto. There , however, a cat

ap betwee the expecte uber o people wth

eeta a the uber o aoe ae

the UK: ol 60 o the expecte 122 people wth

eeta per 1,000 people over 80 ear o ae

have bee orall aoe.8 several barrer have



11/38

9

bee ete whch a expla th ap, uch a

ear o the eae the patet or al, ablt to

eparate eeta pto ro oral ae

proce, gP lack o tra a coece ao eeta, uclear role or cotet

approache o pecalt ervce uch a meor

servce, a varato a cotec the

avalable aotc tool.8

no terveto have et bee evelope that

prevet, chae or revere the proreve ecle

o bra ucto. There are, however, a uber

o potetal pharacolocal (e.. choleterae

hbtor), a o-pharacolocal (e.. cotve

behavoural therap) terveto that ocu o

treat the pto o eeta.6 neverthele,

people wth eeta are at a creae rk o

phcal health proble a becoe creal

epeet o health a ocal care ervce

a other people. The proreve ature o the

eae aocate wth cat chae o

al lv actvte, behavour, appette a eat

habt, a ake people ore uceptble to

other eae. Th wll be tralate to ultple

cotact wth the natoal Health servce a ocal

care ervce toether wth creae relace oal a re or upport. Aot all carer,

the carer o people wth eeta are oe o

the ot vulerable, uer ro hh level o

bure a etal tre, epreo, ult a

pcholocal proble.6;9 The behavoural a

pcholocal pto o eeta patet, uch

a areo, atato a axet, are partcularl

cult or carer a are a coo caue or

ttutoalato o eeta patet care

hoe.5 it thereore well recoe that eeta

ha a cat ecooc pact o the health

care te, o patet, o al a re who

prove upa care, a o the we ecoo a

ocet.

depte the hh bure o eeta, there are

cocer that t ao a treatet the

UK eerall low. A teratoal coparo

publhe 2007 uete that the proporto

o patet recev pharacolocal treatet

the UK wa le tha hal the level coutre

uch a swee, irela, Frace a spa.10

Furtherore, a report ro the natoal Aut Oce

2007 ete everal proble the ervce

a upport or people wth eeta a et up a

lt o recoeato to are thee.8 i 2009,

the departet o Health releae the rt natoaldeeta strate or Ela ett out a work

prorae over ve ear to prove eeta

ervce acro three area: prove awaree,

earler ao a terveto, a hher qualt

o care.11 Th wll volve a vetet over the rt

two ear o 150 llo to u the pleetato

o the strate.

Th report a to etate the ecooc bure

o eeta the UK 2008 ro a ocetal

perpectve that clue ot ol health care cot

but alo thoe cot all oute the health care

ector, uch a ocal care cot, the opportut

cot aocate wth upa care to patet,

a prouctvt loe aocate wth preature

eath or abece ro work ue to eeta. Cot

o lle (COi) tue, uch a th, ca help to

or reearch prorte b prov etate

o the ecooc bure o partcular publc

health proble. i COi tue ca be perore

cotetl acro everal eae t wll be

poble to et a cot copoet a rakeae accor to ther ecooc bure. Th

ca the be ue to help pla the allocato o uture

reearch u towar thoe eae wth the

reatet bure.

However, eco a polc aker are ote ace

wth everal COi etate that var coerabl

wth a acro eae. Thee varato

are lkel to be ue part to the ue o eret

perpectve, cope a etho to etate

cot, ra cocer about the coparablta ueule o COi tue to or reearch

eco.12 U a coo approach acro

all eae o teret ca help overcoe thee

culte. Hece, aother a o the report wa

to copare the cot o eeta wth cacer,

coroar heart eae (CHd) a troke u

the ae ethoolocal approach. Thee three

eae are the a caue o eath the

Weter worl. The ethoolocal raework o

our cot aal wa prevoul ue to etate

the ecooc bure o carovacular eae,CHd

a troke the UK.13-16 i th report, we prove


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10

ew etate or cot o eeta a cacer

a upate the prevou CHd a troke tue to

2008 prce.

i the UK, a overetal revew publhe

2006 vetate how publc boe houl taret

ecal reearch u.17 A recoeato

co ro the revew wa that the pact o

eae o the UK populato a ecoo

houl be aee to etere the UK health

prorte whch wll tur or UK health reearch

prorte. To evaluate the curret u tuato

the UK, overetal a chart reearch u

wa quate or eeta, cacer, CHd a

troke the acal ear 2007/08. The a wa to

copare the level o UK reearch u wth the

repectve etate ecooc bure o eae

a evaluate whether health reearch prorte are

lke wth the repectve ecooc bure.

Structure o the report

The reaer o the report ve to x

ecto a ollow:

Section 2 ecrbe the ethoolo ue to

etate the ecooc bure o eeta a

cacer;

Section 3 ecrbe the ethoolo ue to

etate the overetal a chart health

reearch u or eeta, cacer, CHd a

troke;

Section 4 etate the cot o eeta a

cacer whch are copare aat CHd a

troke;

Section 5 et out the level o overet a

chart reearch u or the our coto acopare reearch u wth eae prevalece

a ecooc bure; a

Section 6 cue the reult a the ke

ltato o our approach.

SECTION 2

METHODS: COST OF ILLNESS STUDY

2.1 INTRODUCTION

A cot tu cot o the etcato,

eaureet a valuato o all reource relate

to a lle, whch all reource coue

b patet are eaure a acrbe u a

oetar value.12 The perpectve o the aal

uaetal eter whch reource houl

be clue, a how the houl be eaure a

value.13 A health ervce perpectve, or tace,

woul ol coer cot poe o hoptal a

other health care prover. A ocetal perpectve

eable a wer aal, whch all cot are

coere, rrepectve o who bear the or

where the are curre. such a perpectve ot

ol clue health care cot but alo thoe cot

all oute the health care ector, uch a ocal

care cot, the opportut cot aocate wth

upa (.e. oral) care to patet, or prouctvt

loe aocate wth preature eath or abece

ro work ue to lle.

U a ocetal perpectve th tu evaluate

the cobe cot o eeta a Alheer

eae (Ad), ee here a iteratoal stattcal

Clacato o deae a Relate Health

Proble 10th Revo (iCd-10)18 F00-F03 a

g30, a collectvel reerre to a eeta

th report. Thee cot wll the be copare to

thoe o cacer (iCd-10: C00-d48), troke (iCd-10:

i60-i69), a coroar heart eae (CHd, iCd-10:

i20-i25).

The raework ue to etate health care a

o-health care cot lar to the approach b

Leal et al (2006),13 Lueo-Ferae et al (2006),14

Leal et al (2008),15 a Leal et al (2009)16 to etate

the ecooc bure o carovacular eae

(CVd), CHd a troke the Europea Uo a

the Ute Ko (UK). i ato, the reult

o thee tue were upate to 2007/08 prce

u recet ut cot,19;20 a approprate fato

ce or health a ocal care cot20 a wae

fato ce,21;22 orer to copare thee cot

wth thoe o eeta a cacer.



13/38

11

i orer to evaluate the cot o eeta a

cacer a aual te rae wa aopte or our

aal, whch all cot ue to the eae

uer vetato wth the ot recet earor whch ata were avalable were eaure,

rearle o the te o eae oet. All health

care a o-health care cot were expree

2008 prce. A top ow approach wa eploe

to calculate the total expeture ue to thee

coto acro the UK. Th approach ue

areate ata o orbt, ortalt, hoptal

ao, eae relate cot, a other health

relate cator.

A varet o atoal ource o epeolocal

a health care utlato ata were ue. Ao

the ource coulte were the Oce o natoal

stattc (Ons), the iorato servce dvo

scotla (isd), the departet o Health (doH),

the Health a socal Care iorato Cetre, the

departet or Work a Peo (dWP), Hoptal

Epoe stattc (HEs), the Labour Force surve

(LFs), the Aual surve o Hour a Ear

(AsHE), the Hm Reveue a Cuto stattcal

Oce, a the doH Qualt a Outcoe

Fraework.

2.2 COSTS OF DEMENTIA

2.2.1 Number of dementia cases in the UK

The uber o cae o eeta wa obtae

ro the Europea Cout Cocerte Acto

o the Epeolo a Preveto o deeta

(EUROdEm) tu.23;24 A part o EUROdEm, ata

o the prevalece o aoe a uaoe

oerate to evere eeta populato-bae

tue a urve coucte everal Europea

coutre, clu the UK, were poole to obta

a et o prevalece rate or e a woe 9

eret ae roup (30-59, 60-64, 65-69, 70-74,

75-79, 80-84, 85-89, 90-94 a 95-99) or the UK

a 30 other Europea coutre (Table 1).

Table 1 EUROdEm prevalece rate o aoe

a uaoe eeta the UK

Age group, years Male Female

30-59 0.16% 0.09%

60-64 1.58% 0.47%

65-69 2.17% 1.10%

70-74 4.61% 3.86%

75-79 5.04% 6.67%

80-84 12.12% 13.50%

85-89 18.45% 22.76%

90-94 32.10% 32.25%

95-99 31.58% 36.00%

Prevalece rate were the apple to the latet

etale UK populato etate erve ro

the goveret Actuar departet or 2006.25

i ato, prevalece rate were alo obtae

ro a Expert delph Coeu exerce o te

UK a Europea expert a apple to the UK

2006 populato.5 Althouh th orato wa ot

ue the a aal, t wa ue a eparate

etvt aal to how the pact o prevaleceo the cot o eeta.

2.2.2 Social care

LOng TERm CARE: nURsing And REsidEnTiAL

CARE HOmEs

nur a reetal care wa eaure a

the uber o eeta-relate week pet

care hoe. There are two tpe o care hoe,

ur hoe a reetal hoe. A reetal

hoe prove care or people who are ot able to

aae evera tak or ata a epeet

hoe o ther ow whle a ur hoe prove

24-hour ur care.

U orato o the UK populato ae 65

ear or ore25 a the proporto o th populato

lv lo-ter care ttuto,26 we etere

the uber o people ae 65+ lv lo-ter

care ttuto the UK. (due to lack o ata,

we coervatvel aue that o patet wth

eeta uer the ae o 65 ear woul be

ttutoale.) Fall, the uber o people lv

thee ttuto wth eeta wa etate


14/38

12

u prevalece ata ro a UK populato-bae

tu o 13,004 elerl people (.e. the mecal

Reearch Coucl Cotve Fucto a Ae

stu mRC CFAs).27

Th tu aee theprevalece o eeta thoe lv reetal

a ur care hoe o the ba o a clcall

orete aeet tervew.

The weekl cot o reetal a o ur

hoe care were erve ro the UK Ut Cot

o Health a socal Care a reporte the

ear 2008 copeu.20 Thee two cot

were the cobe to a weekl cot o lo-

ter ttutoale care, wehte to refect

the proporto o patet lv each tpe o

ttutoal care, whch wa erve ro the mRC

CFAs tu.27 Thee cot were the coverte

to aual cot, a ultple b the uber o

eeta cae lv lo-ter ttutoale

accooato.

2.2.3 Health care

PRimARy CARE

Prar care actvte cote o eeta-

relate vt to eeral practtoer (gP), gP

hoe a telephoe vt, ure vt at clc, a

ure hoe vt.

The coultato rate o patet wth eeta

were obtae ro publhe evece ro a tu

etat the relatohp betwee the cot o

eeta care a eae proreo.28 Althouh

all patet that tu were erve ro a le

eoraphcal locato the UK, .e. Oxorhre, the

patet aple wa how to be repreetatve o

the eeral populato wth rear to the trbuto

o ocal cla.29 That tu prove orato othe uber o prar care vt over a pero o

up to 11 ear ro ao ae b 100 patet

aoe wth ether Ad or vacular eeta, wth

eparate coultato rate or thoe patet lv

the cout a thoe lv ttutoale

care ett. Thee coultato rate were the

apple to the uber o eeta patet lv

ttutoale ett a thoe lv the

cout. The uber o eeta patet lv

the cout wa etate b ubtract the

total uber o patet lv ttutoale

lo-ter care ro the total uber o etate

eeta cae the UK. The total uber o

prar care coultato ue to eeta wa

the ultple b ther ut cot. Ut cot were

obtae ro the UK Ut Cot o Health asocal Care or the ear 2008 copeu.20

HOsPiTAL OUTPATiEnT VisiTs

Hoptal outpatet care copre all eeta-

relate coultat vt tak place outpatet

epartet acute care ttuto.

The outpatet vt rate o patet wth eeta

were obtae ro the ae tu a that ue

to etere prar care coultato.28 A wth

prar care, vt rate were obtae eparatel

or thoe patet lv lo-ter care ttuto

a thoe lv the cout a were

ultple b the etate uber o eeta

patet lv thee two ett. The total

uber o outpatet vt ue to eeta wa

the ultple b ther ut cot. Ut cot were

obtae ro the nHs Reerece Cot scheule

or the ear 2007/08.19

ACCidEnT & EmERgEnCy VisiTs

Accet a eerec (A&E) care cote o all

eeta-relate hoptal eerec vt.

Ue o A&E ervce wa erve ro a tu o

132 people aoe wth eeta south

Loo, o whch 101 lve the cout a

31 ttutoale ett.30 Th tu prove

orato o the proporto o patet acce

A&E ervce over the lat three oth, whch wa

the ultple b our to obta a aual etate.

A the tu howe o erece A&E ue

betwee patet lv the cout or

ttuto (p=0.742), A&E vt rate were ultple

b the total uber o eeta cae the UK,

wthout urther tratcato b lv arraeet.

The total uber o A&E v t ue to eeta

wa the ultple b ther ut cot. A&E ut

cot were obtae ro the nHs Reerece Cot

scheule or the ear 2007/08.19

HOsPiTAL inPATiEnT CARE

Hoptal patet care wa etate ro the

uber o a hoptal ue to eeta, whchclue rehabltato eo, cout hoptal



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13

repte care a hoptal a cae. Hoptal

a cae ao were obtae eparatel

ro hoptal patet care. i Ela, hoptal

patet ta a a cae were obtae rothe Hoptal Epoe stattc (HEs) b prar

ao o eeta a Alheer eae. i

Wale, scotla a norther irela, equvalet

orato wa obtae ro ther repectve

tattcal boe.31-33 Ut cot or a hoptal be

a a a cae were the obtae ro nHs

Reerece Cot scheule or the ear 2007/08,19

u the Health Reource group (HRg) or

Alheer eae.

i ato, orato wa obtae ro HEs, a

t couterpart Wale, scotla a norther

irela, o patet ta a a cae where

eeta a Alheer eae were uerl

caue or the hoptalato, rather tha the

prar ao. Althouh th orato wa

ot ue the a aal, t wa ue a

eparate etvt aal how the cot o all

eeta-relate hoptalato.

mEdiCATiOns

The cot relate to coupto o at-eeta, atpchotc, axoltc, hpotc a

atepreat ecato b eeta patet

were clue the aal.

Cot o at-eeta ecato (.e. oepel,

alatae, rvate a eate) were

erve ro the Precrpto Cot Aal (PCA) or

each o the our coutre the UK34-37. The PCA

prove etal o the uber o te a the et

reet cot o all precrpto pee the

cout.

The ue o atpchotc, axoltc, hpotc a

atepreat ecato aot eeta

patet wa obtae ro a tu o 445 people

south Eat Ela lv ur hoe,

o whch 74% ha probable clcal eeta.38

The proporto o reet reularl tak thee

ecato wa ultple b the total uber o

eeta cae the UK. The ot precrbe

ru each ecato roup were the ete

ro the PCA a t aual cot per pero wa

ultple b the uber o eeta uer.

A the PCA ata oe ot clue a pe

cot or ee, the ru pe ee per

precrpto wa ae to the total ecato cot

o eeta patet.39

PRiVATE HEALTHCARE

Curretl 12.7% o all health care the UK

be prove prvatel,21 but orato o the

breakow o th b eae tpe lte. We

aue here that patter o prvate health care

ue parallel publc ervce, a accout or th b

fat publc health care expeture o prar,

outpatet, A&E, a hoptal patet care b

12.7%.

2.2.4 Informal care

ioral care cot are equvalet to the opportutcot o upa care. Th opportut cot ca be

coere a eaure o the aout o oe

that carer oro to prove upa care or ther

poue, re or relatve uer ro eeta.

For th aal we aue that ol thoe

patet lv the cout woul receve

oral care.

The averae hour per week pet b relatve a

re prov upa care or eeta uerer

wa obtae ro scheer et al. (2002).30 Th

tu o 101 patet lv the cout, ake

carer how uch te wa pet over oe week

prov care three prcpal or:

1: eeral tak (.e. hopp, paperwork,

cook, eat eal a other houehol

chore);

2: pecc tak (.e. bath, re, roo

a prov traport); a

3: upervo. The averae hour per week

prov oral care were the ultple

b the uber o eeta cae lv the

cout, a auale b ultpl b 52

week.

To value the aout o oral care prove, care

prove b eploe carer wa value u the

eer-pecc averae wae the UK,22 wherea

care prove b ueploe, actve or retre

carer wa value u the u wae.40

To etere the eploet tatu o the carer

we ue orato ro the tu b scheer

et al. (2002) 30 o the carer relatohp wth the

patet (poue, o/auhter, o/auhter law,


16/38

14

bl, other relatve or re) a the eer o

the carer. due to the avace ae o the patet

roup th tu (ea ae wa 80 ear),

we aue that poue, bl a reprov the care woul tpcall be ae 65 ear

o ae or ore, a thereore be retre. i care wa

be prove b ether the patet chlre or

ther chlre poue, the t wa aue that

thee oral carer woul be uer 65 ear o

ae. U eer-pecc ecooc actvt a

ueploet rate,41 we the etere the

proporto o thee carer who were eploe or

ueploe/ecoocall actve.

2.2.5 Productivity losses

mORTALiTy LOssEs

The cot aocate wth lot prouctvt ue to

ortalt copre the oreoe ear ro

preature eath ue to eeta. Ae a eer

pecc eath, where the a caue wa ether

eeta or Alheer eae, were obtae

ro UK ortalt atabae.42-44 death where

eeta or Alheer eae wa the uerl

caue o eath were alo obtae a clue

our aal.

UK labour tattc report ecoocall actve

vual ro ae roup 16-17 to 65+ ear o

ae.41 We ue a tal work ae or both e

a woe o 16 ear a aue that above 70

ear o ae the proporto o people work woul

be elble. The uber o work ear lot ue

to preature ortalt wa etate both or ale

a eale, u expecte work ear let

b ae roup toether wth the uber o eath

broke ow b ae a eer. However, ot

everoe o work ae wll be ecoocall actve

(.e. ether work or actvel earch or work) or

eploe. Thereore, the etate work ear

lot ue to preature ortalt were ajute u

ae a eer pecc ueploet a actvt

rate or the UK.41 The averae aual ear

o ale a eale worker were take ro the

Aual surve o Hour a Ear.22 The prouct

o thee ear a potetal work ear lot

prove the ortalt cot ue to eeta.

A thee prouctvt cot woul be curre

uture ear, all uture oreoe ear were

coute u a 3.5% rate per au ollow

curret UK Hm Treaur recoeato.45

A eparate etvt aal wa uertake

how b how uch cot woul creae

eath where eeta wa the uerl caue

were clue the aal.

mORBidiTy LOssEs

The orbt cot ue to eeta clue the

uber o a lot covere b capact cla,

a other work a lot.

The uber o capact beet work a ue

to eeta wa obtae ro the departet

o Work a Peo iorato Cetre,46 whch

prove the a o certe capact the perobetwee Aprl 2001 a march 2002 b eer a

ao (a coe iCd-10).

The uber o work a lot ot covere b

capact cla wa obtae ro a report b the

Chartere ittute o Peroel a developet,47

whch prove the work a lot ue to all-

caue lle per worker or the UK. The averae

uber o work a lot wa the ultple b

the total uber o eploe people the UK.41 To

etere the uber o work a lot ue to

eeta, the total a lot wa ultple b the

proporto o capact a clae or eeta

the UK.46

The prouct o work a lot a averae al

ear prove the prouctvt loe aocate

wth eeta orbt. However, abet worker

ater a certa pero are lkel to be replace at

work b other worker, a o the total orbt

lo a copute above lkel to be a upper

lt o the real lo ro eeta. Hece, we

etate the rcto pero, .e. the pero o

eploee abece ro work ue to lle beore

he or he replace b aother worker, whch

etate to be 90 a Europe. The rcto

pero ajute orbt lo wa the etate

b ultpl the uajute prouctvt lo

etate b the rcto pero, a v th

prouct b the averae urato o each pell o

work capact; th wa etate th tu to

be 232 a o averae, ollow the etate

ue b Leal et al (2006)13

a Lueo-Feraeet al (2006)14 whe etat the bure o

carovacular eae.



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15

2.3 COSTS OF CANCER

2.3.1 Social care

HOsPiCE PALLiATiVE CARE

Hopce care cote o all cacer-relate ta

hopce prov e o le a pallatve

care acro the UK. We ol coere ta

epeet hopce, .e. thoe ue b charte

a other ot-or-prot oraato, a pallatve

care ue b the nHs wa alrea clue uer

patet hoptal care.

A report ro the natoal Aut Oce (nAO)

prove the aual expeture o all epeet

hopce care prover Ela a well athe proporto o total eath ue to cacer.48

The prouct o the aual expeture a the

proporto o eath ue to cacer prove the

total aual hopce expeture o cacer. B

u Ons ata o the uber o eath ue to

cacer hopce44 a the proporto o hopce

care that wa prove epeetl48 t wa

poble to etate the uber o cacer-relate

eath occurr epeet hopce. The care

cot per pero o cacer a epeet

hopce Ela wa etate b v

the aual hopce expeture o cacer b the

uber o cacer eath hopce.

Au that the proporto o cacer-relate

eath occurr epeet hopce wa the

ae acro Ela a Wale, norther irela

a scotla, the proporto o all cacer-relate

eath epeet hopce wa apple to the

total uber o cacer eath each coutr.42-44

Fall, t wa aue that the cot per cacer

eath a epeet hopce or Elawoul be the ae Wale, norther irela a

scotla.

2.3.2 Health care

PRimARy CARE

Prar care actvte cote o cacer- relate

gP vt at clc, gP hoe a telephoe vt,

ure vt at clc, a ure hoe vt.

i orer to obta the uber o cacer-relate

prar care coultato, the proporto oprar care vt ue to cacer49 wa apple to

the total uber o coultato prar care or

all eae a coto.50-53 The total uber

o prar care coultato ue to cacer wa

the ultple b ther ut cot. Ut cot wereobtae ro the UK Ut Cot o Health a

socal Care or the ear 2008 copeu.20

HOsPiTAL OUTPATiEnT VisiTs

Hoptal outpatet care copre all cacer-relate

coultat vt tak place outpatet war

acute care ttuto.

i orer to evaluate the uber o cacer-relate

coultat vt, the proporto o outpatet vt

ue to cacer wa apple to the total uber

o hoptal outpatet vt. The proporto o

outpatet vt each ecal pecalt ue to

cacer wa obtae ro a scotth report,54

whch coultat work wth each ecal

pecalt were ake to prove, bae o ther

expert opo, the proporto o all vt attrbutable

to cacer. Thee proporto were the apple to

the total uber o outpatet vt each ecal

pecalt, whch wa obtae ro routel

collecte UK ata.55-58 The total uber o cacer-

relate outpatet vt each pecalt wathe ultple b ther ut cot. Ut cot were

obtae ro the nHs Reerece Cot scheule

or the ear 2007/08.19

ACCidEnT & EmERgEnCy VisiTs

A&E care cote o all cacer-relate hoptal

eerec vt. A wth outpatet vt, the

proporto o total A&E vt ue to cacer wa

obtae ro a report evaluat the cot o

cacer scotla.54 The proporto o total A&E

vt ue to cacer wa the apple to totalA&E vt the UK, aa erve ro routel

collecte tattc.55-58 The total uber o A&E

vt ue to cacer wa the ultple b ther ut

cot. A&E ut cot were obtae ro the nHs

Reerece Cot scheule or the ear 2007/08.19

HOsPiTAL inPATiEnT CARE

Hoptal patet care wa etate ro the

uber o a hoptal ue to cacer, whch

clue hoptal-bae pallatve care a hoptal

a cae. Hoptal a cae ao were

obtae eparatel ro hoptal patet care.


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16

Hoptal patet ta a a cae b prar

ao o cacer were obtae ro HEs

Ela,55 a ro t couterpart Wale,32

scotla,33

a norther irela.59

Ut cot or ahoptal be a a a cae were the obtae

ro the nHs Reerece Cot scheule or the ear

2007/08.19 The ut cot obtae were the cot

per be a a a cae or patet roupe

the Health Reource group (HRg) or cacer.

mEdiCATiOns

Cot relate to coupto o ecato b

cacer patet were clue the aal.

The cot o cacer ecato clue all

expeture o Brth natoal Forular (BnF)Chapter 8 ecato, .e. malat deae

a iuouppreo, wth expeture o

uouppreo ecato be exclue.

Expeture o ecato wa obtae ro the

Precrpto Cot Aal (PCA) or each o the our

coutre the UK,34-37 to whch pe cot

were ae.39

PRiVATE HEALTHCARE

A curretl 12.7% o all health care the UK

be prove prvatel,21 to accout or th prvate

pe all nHs healthcare cot (.e. prar,

outpatet, A&E, a hoptal patet care) were

fate u th proporto.

2.3.3 Informal care

ioral care cot were equvalet to the

opportut cot o upa care. Th opportut

cot a eaure o the aout o oe that

carer oro to prove upa care or ther

poue, re or relatve uer ro cacer.

For th aal we aue that thoe patet

aoe wth o-alat cacer (iCd 10:

d00 to d48) woul ot requre oral care. The

total uber o hour o oral care prove to

patet wth cacer wa obtae b ultpl the

probablt o recev oral care, the uber

o hour o care prove a the total uber o

patet ee o care.

The probablt o recev oral care wa

evaluate or our eret cacer patet roup:

1: ewl aoe patet recev treatet

a urvv pat the rt ear o ao;

2: ewl aoe patet recev treatet

a wth the rt ear o ao;

3: ewl aoe patet recev pallatve

teral care; a

4: patet whoe cacer wa aoe the

pat a who were recev pallatve teral

care.

U cacer retrato tattc or each o the

our coutre the UK, 60-63 we obtae the total

uber o alat cacer cae the UK. U

UK cacer urvval rate,64

we the etate theproporto o cae :

1: the ae ear a that o ao, a

2: oe ear ater ao. Wth th orato

we were the able to etere ro the total

uber o cacer-relate eath the UK42-44

that occurre wth the ae ear a ao

a thoe whch cacer wa aoe

prevou ear.

Bae o orato about the te cacer patet

were abet ro work (ore orato o how

th wa evaluate prove ecto 2.3.4

below), we aue that ewl aoe cacer

patet urvv pat oe ear woul potetall

requre 44 week o oral care whlt the were

recev treatet or the eae.65-71 For ewl

aoe cacer patet wth the rt

ear, we aue that the averae le expectac

woul be 6 oth, wth the rt 3 oth be

treate or the eae a the rea 3 recev

pallatve care. Fall, or patet whoe cacerwa aoe prevou ear, we aue the

woul potetall requre 3 oth o oral care

whlt recev pallatve care.

The probablt o recev oral care whlt

patet were be treate or cacer a ur

the pallatve care phae wa erve ro a UK

tu o 262 patet wth lphoa, breat,

colorectal or lu cacer.72 A the tu ot

prove the total hour o oral care prove,

we ue ata ro the 2001 natoal Ceue,73-75

au that the hour o oral care receve

b cacer patet wa the ae a that prove



19/38

17

or all caue. ioral care prove b eploe

carer wa value u the eer-pecc averae

wae the UK22, wherea care prove b

ueploe, actve or retre carer wa valueu the u wae.40

2.3.4 Productivity losses

mORTALiTy LOssEs

The cot aocate wth lot prouctvt ue to

ortalt were calculate a the oreoe ear

ro preature eath ue to cacer. Ae a

eer pecc eath, where the a caue o

eath wa cacer, were obtae ro UK ortalt

atabae.42-44 The ae ource a etho

ue to etate eeta-relate ortalt cot

were ue to etate ortalt aocate wth

cacer.

mORBidiTy LOssEs

The orbt cot ue to cacer clue the

uber o a lot ue to capact a the

work a lot. The ae ource a etho

ue to etate eeta-relate orbt cot

were ue to etate thoe aocate wth cacer,

the ol erece be the rcto pero ue: or

cacer the rcto pero ue wa 307 a, bae

o reult ro eve tue whch evaluate work

abece ater cacer ao.65-71

SECTION 3

METHODS: RESEARCH FUNDING

3.1 INTRODUCTION

i the UK, reearch to health a ecal cece

ue b a uber o eret oraato

clu the departet o Health, a t

couterpart the evolve atrato; the

UK reearch coucl; charte; a reearch

a evelopet (R&d) vetet ro the

pharaceutcal a botecholo utre.17

The a o th aal wa to exae the level

o reearch u or eeta, cacer, CHd a

troke or the ear 2007/08. i le wth other tue

evaluat the level o UK health reearch u,

reearch u prove b the pharaceutcal

a botecholo utr wa exclue ro the

aal.76-79

3.2 GOVERNMENTAL HEALTH RESEARCH

FUNDING

goveretal aece repoble or u

health reearch were ete ro a report b

the UK Clcal Reearch Collaborato,76 whch

evaluate UK level o reearch u ur the

2004/05 acal ear. goveretal aece

u health reearch clue: the Botecholo

a Bolocal Reearch Coucl (BBRC); the

Eeer a Phcal scece Reearch

Coucl (EPsRC); the Ecooc a socal

Reearch Coucl (EsRC); the mecal Reearch

Coucl (mRC); the departet o Health throuh

the natoal ittute or Health Reearch (niHR); the

Reearch a developet Oce or the norther

irela Health a Peroal socal servce;

the scotth Executve Health departet Che

scett Oce; a the Wale Oce o Reearch

a developet or Health a socal Care.

For each overetal aec, we ouht to

etere the level o reearch u or troke,

CHd, cacer a eeta. The rt tep wa to

browe throuh each o the aece webte

orer to obta orato o the reearch rat

ue b thee oraato (.e. ttle, eae

area a aout o u receve), b earch

throuh ther aual report a/or atabae o

rat. i o aual report/atabae o rat

wa ete, or the orato wa ot etale


20/38

18

eouh, aece were cotacte b electroc

al, bae o the cotact etal prove ther

webte, a ake to prove orato o

the level o reearch u the acal ear2007/08 or the our eae uer vetato.

3.3 CHARITY HEALTH FUNDING

i orer to etere the level o reearch u

o troke, CHd, cacer a b UK charte, we

ete charte potetall u health u

two approache.

Frt, a lt o all the charte that potetall ue

health reearch wa obtae ro the Chart

Coo or Ela a Wale. The Chart

Coo cota a reter o all retere

charte hol etale orato, clu

aual accout a report, or ever retere

chart Ela a Wale.80 The lt o potetall

relevat charte wa obtae b et all

the charte clae, the Chart Coo

reter, a mecal/Health/ scke a

prov oetar u ether b ak rat

to oraato or poor or uertak

reearch. due to the ver hh uber o charte

ete u th earch crtera (=6,751),charte were rake ter o ther aual coe

a ol the rt two hure charte, whch ha

a cobe coe o over 75% o the total, were

coere.

seco, a lt o all the charte that were part

o the Aocato o mecal Reearch Charte

(AmRC) wa obtae. The AmRC, a etablhe

chart ce 1987, a eberhp oraato

o the lea UK charte that u ecal a

health reearch. i orer to jo the AmRC, charte

ut eotrate that the have a clear reearch

trate, have a peer revew proce or allocat

u, a upport AmRC poto tateet

o ue uch a paet o rect cot

uverte a ue o aal ecal reearch.81

At the te o th reearch, the AmRC cote o

116 charte wth a jot pe o over 800 llo

o ecal a health reearch the UK.81

Charte ete ether throuh the Chart

Coo or AmRC a potetall u health

reearch were ol exclue ro the aal

the:

1: were retere aother coutr, rearle o

the level o health reearch u the UK,

a were thereore uer o oblato to le

ther accout a aual report the UK; or

2: were eucatoal/reearch oraato,

uch a uverte, or roal collee that

were retere a charte. Roal collee

a eucatoal/reearch oraato were

exclue a a reat proporto o ther coe

receve throuh exterall ue rat

rather tha chartable oato, eowet

or leace. Thereore, to e the potetal

o ouble cout the ae reearch u,

thee oraato were exclue.

For each chart, we ouht to etere the

chart ue health reearch a, o, the level

o u or troke, CHd, cacer a eeta.

We exclue reearch expeture o upport

cot uch a atrato a ratructure

(e.. reearch bul), but clue ue

reearch tak place oute o the UK. iorato

o whether each chart wa volve health

reearch, a o, the level o reearch u o

the our eae uer vetato wa obtae

three tep wth all the ata extracte u

a tructure proora (Appex 1). Frtl, the

chart aual report a accout were obtae.

For charte retere Ela a Wale,

a cop o the aual report a accout wa

avalable throuh the Chart Coo. Aual

report were the revewe to obta orato

o the reearch rat ue. secol, the

orato cotae wth the aual report

wa ot etale eouh, the chart webte

wa browe orer to et a atabae oall the rat or health reearch wa avalable.

i o relevat orato wa obtae ro the

chart webte, the al thr tep, charte

were cotacte b electroc al a ake

the ue health reearch a o the level o

reearch u the acal ear 2007/08 or the

our eae uer vetato.

A charte clue the tu coul potetall

ake rat to each other, the aual report a

accout were checke orer to et whether

a o ther reearch u cae ro rat ro

other charte alrea clue the aal. Th

wa uertake a b ot to ouble cout the

ae reearch u.



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19

SECTION 4

RESULTS: COSTING STUDIES

4.1 COSTS OF DEMENTIA

4.1.1 Prevalence of dementia in the UK

The etate uber o patet wth aoe

a uaoe eeta the UK wa 821,884

(Table 2), repreet 1.3% o the UK populato. O

total cae, 318,010 (39%) were e a 503,874

(61%) were woe. 61% (=499,166) o eeta

cae occurre vual ae 80 ear or ore,

a 64,037 (8%) cae were ete or thoe

ouer tha 65 ear o ae, wth eeta be

ore prevalet ale th ae roup.

Table 2 nuber o aoe a uaoe

eeta cae the UK 2006

Age group,

years Male Female Total

30-59 19,840 11,381 31,221

60-64 25,034 7,782 32,816

65-69 28,056 15,378 43,434

70-74 50,085 48,319 98,404

75-79 42,805 74,037 116,842

80-84 68,343 120,482 188,825

85-89 50,439 124,465 174,903

90-94 28,399 78,606 107,006

95-99 5,008 23,424 28,432

Total 318,010 503,874 821,884

4.1.2 Social care costs

We etate that 304,850 patet ae 65

ear or ore wth eeta woul be lv

ttutoale lo ter care, repreet

approxatel 37% o all eeta patet the

UK (Table 3). Wth accooato lo-ter

ur a reetal care ett eerat a

aual cot o approxatel 30,000 per patet,

the aual cot o lo-ter care accooato

ue to eeta wa exce o 9 bllo.

4.1.3 Health care costs

There were over 7 llo prar care coultato

the UK ue to eeta, wth earl 50%, 3.6

llo, cot o gP hoe vt. Th reulte

a aual cot to the healthcare te o over

317 llo, two thr o whch wa attrbutable

to hoe gP vt. For the ae ear there were

298,867 A&E vt a 489,766 outpatet

coultato ue to eeta. Th repreete a

aual cot o over 26 llo A&E care a 55

llo outpatet coultato (Table 3).

Table 3 a 4 how there were a total o earl

1.5 llo patet be a a a cae ue

to a prar ao o eeta. ipatet carereulte a aual cot o over 463 llo, wth

the reat ajort o thee cot relate to overht

ta hoptal. However, whe hoptalato

ue to eeta a a uerl caue were alo

clue the aal, the uber o hoptal be

a creae to earl 4.3 llo a the uber

o a cae wa earl 7,000. Au that there

wa o erece the cot o a hoptal be a

or a cae whether eeta wa the prar

ao or a uerl caue, the eeta-

relate patet cot creae earl three-ol

to 1,344 llo whe hoptalato ue to

eeta a a uerl caue were clue

the aal (Table 4).


22/38

20

Total aual expeture o eeta-relate

ecato, clu pe ee, wa

228 llo. nearl hal o th expeture, 100

llo, wa o at-eeta ru (.e. oepel,

alatae, rvate a eate), wth the

rea expeture, 128 llo, be ue to

precrpto or atpchotc, axoltc, hpotc

a atepreat ecato (Table 3).

Table 4 setvt aal: hoptalato b eeta ao

Primary diagnosis Any diagnosis

nuber o be-a 1,485,471 4,254,061

Ut cot, 311 311

Total cot o be-a, 462,589,784 1,324,754,919

nuber o a cae 209 6,924

Ut cot, 2,775 2,775

Total cot o a cae, 575,898 19,078,805

Total cost, 463,165,682 1,343,833,725

Table 3 Cot o eeta the UK

Type o resource used Unit o measurement Units o Average unit Total cost,

resources cost, thousands,

consumed

HEALTH CARE

Prar care nure hoe vt 2,492,220 26 64,798

nure urer vt 186,753 9 1,681

gP hoe vt 3,567,046 58 206,889

gP urer vt 1,161,197 36 41,803

gP telephoe vt 83,939 22 1,847

Total 317,017

A&E Atteace 298,867 89 26,737

Outpatet care Atteace 489,766 112 55,044

ipatet care Hoptal be-a 1,485,471 311 462,590

Hoptal a cae 209 2,755 576

mecato 228,399

Prvate care Prvate part o total health expeture 12.70% 109,469

Health care cost subtotal 1,199,832

SOCIAL CARE

Lo-ter care year lo-ter care accooato 304,850 29,822 9,091,177

Social care cost subtotal 9,091,177

NON-HEALTH/SOCIAL CARE

ioral care Hour o care prove b ecoocall

actve carer 512,457,980 13 6,671,816

Hour o care prove b ecoocall

actve carer 996,638,065 6 5,710,736

mortalt Work ear lot (e) 2,025 32,838* 22,515

Work ear lot (woe) 1,933 18,958* 5,994

morbt (rcto ajute) Certe capact a 160,603 104 16,743

Work a lot 38,380 104 4,001

Non-health/social care subtotal (riction adjusted) 12,431,804

Total economic burden (riction adjusted) 22,722,813

*Future ear coute u a aual rate o 3.5%.



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21

Cob all healthcare cot ue to eeta, the

total cot to the nHs wa 1,090 llo ol the

cot o hoptalato or eeta a a prar

ao were clue. iclu prvate healthcareexpeture o eeta, the total cot to the

healthcare te woul creae to 1,200 llo.

i however, all eeta-relate hoptalato

were clue the aal the cot to the nHs

woul creae to 1,971 llo, a thoe to the

healthcare te to 2,192 llo.

4.1.4 Informal care costs

A total o 1,509 llo hour o oral care

wa prove b re a relatve o the

517,033 eeta patet lv the cout.Approxatel 34% (512 l lo hour) o th care

wa prove b ecoocall actve a eploe

relatve/re, wth the ajort o care (997

llo hour) be prove b retre, actve or

ueploe oral carer. Cobe, the total

aual cot o oral care-v were etate

at 12,383 llo (Table 3).

4.1.5 Productivity costs

There were a total o 23,418 eath wth eeta

retere a the a caue o eath, o whch 610

(3%) occurre patet uer the ae o 70 ear.

Th reulte a etate lo o 3,958 work

ear lot, reult aual cot o 34 llo

whe uture oreoe ear were ot coute,

a 29 llo ater cout uture ear

(Table 3 a 5).

Whe eath wth eeta retere a a

uerl caue were accoute or, there were a

total o 53,676 eeta-relate eath, o whch

1,371 (3%) occurre patet uer the aeo 70 ear, reult a lo o 9,243 work

ear (Table 5). Th eerate prouctvt loe

o 82 llo whe uture oreoe ear were

ot coute, a 68 llo whe thee were

coute.

Table 5 setvt aal: eeta eath

b caue

Main Main &

cause underlyingcauses

nuber o eath 23,418 53,676

nuber o eath, < 70 ear 610 1,371

Potetal work ear lot 3,958 9,243

mortalt cot ,

ucoute 33,956,727 82,359,860

Mortality costs ,

discounted 28,508,341 68,300,834

A etate 512,936 a o work were lot ueto cke abece or capact relate wth

eeta. Th repreete a cot o 53 llo,

whch whe ajute b the rcto pero reulte

a cot o jut uer 21 llo.

Overall, eeta wa ou to cot 22.7 bllo

ter o health a ocal care, oral care a

prouctvt loe 2008. O thee cot, 5% were

ue to healthcare, 40% to ocal care a 55% to

oral care, wth prouctvt loe accout or

le tha 1% o total cot.

4.1.6 Sensitivity analysis: Prevalence rates

U prevalece rate ro the Expert delph

Coeu roup,5 the etate uber o

patet wth eeta the UK wa 701,143.

The proporto o eeta cae occurr

vual ae 80 ear or ore wa 67%,

wherea ol 2% o total cae were precte

thoe ouer tha 65 ear o ae. i prevalece

rate ro th tu were ue to re-calculate the

cot relat to prar, eerec, outpateta pharaceutcal, the cot to the nHs woul

be 1,011 llo, a thoe to the health care

te woul be 1,113 llo. Thee prevalece

rate woul alo alter our etate o oral

care, reult a total o 1,157 llo hour o

care prove to 396,293 eeta patet the

cout, a lhtl ecrea the total cot o

oral care to 9,941 llo.

Thereore, u the prevalece rate ro the

Expert delph Coeu roup, the cot o

eeta to the UK ecoo ecreae ro 22.7

bllo whe u EUROdEm rate to 19.7 bllo,


24/38

22

o whch 6% wa ue to healthcare, 46% ue to

ocal care a 48% ue to oral care.

4.2 COSTS OF CANCER

4.2.1 Social care

O the159,520 retere eath wth cacer a the

a caue, 20,233 occurre epeet (.e.

o-nHs) hopce, wth a etate aual cot

o 572 llo (Table 6).

4.2.2 Health care costs

There were over 4 llo prar care coultato

the UK ue to cacer, wth over hal, 2.2 llo,

cot o gP urer vt. Th reulte a

aual cot to the healthcare te o over 127

llo. For the ae ear there were 314,000 A&E

vt a earl 7.5 llo outpatet coultato

ue to cacer. Th repreete a aual cot

o 28 llo A&E care a 793 llo

outpatet coultato (Table 6).

Table 6 how a total o over 5 llo patet be

a a exce o 1 llo hoptal a cae

ue to a prar ao o cacer. Th reulte

a aual cot o over 2.3 bllo, o whch 1.8

bllo wa accoute b overht ta hoptal

a the rea 500 llo b hoptal a

cae.

For cacer patet, the two ot cool

precrbe ecato were taoxe ctrate

a aatroole, accout or 753,183 (20%)

a 671,987 (18%), repectvel, o the 3,753,525

precrpto pee or cacer. The total aual

expeture o thee two ecato wa 62llo, repreet 19% o the 326 llo total

aual expeture o cacer-relate ecato,

clu pe ee (Table 6).

Table 6 Cot o cacer the UK

Type o resource used Unit o measurement Units o Average unit Total cost,

resources cost, thousands,

consumed

HEALTH CARE

Prar care nure hoe vt 296,398 26 7,706nure urer vt 599,857 9 5,399

gP hoe vt 293,855 58 17,044

gP urer vt 2,203,111 36 79,312

gP telephoe vt 806,857 22 17,751

Total 127,211

A&E Atteace 313,974 89 28,088

Outpatet care Atteace 7,482,712 106 792,857

ipatet care Hoptal be-a 5,310,423 340 1,807,504

Hoptal a cae 1,135,127 441 500,336

mecato 326,117

Prvate care Prvate part o total health expeture 12.70% 413,512

Health care cost subtotal 3,995,625

SOCIAL CARE

Hopce care Cacer cae hopce care 20,233 28,255 571,687

Social care cost subtotal 571,687

NON-HEALTH/SOCIAL CARE

ioral care Hour o care prove b ecoocall

actve carer 58,527,648 14 791,308

Hour o care prove b ecoocall

actve carer 83,086,320 6 476,085

mortalt Work ear lot (e) 329,863 32,838* 4,165,990

Work ear lot (woe) 316,239 18,958* 1,573,951

morbt Certe capact a 11,183,000 104 1,165,828

Work a lot 2,672,476 104 278,606

Non-health/social care subtotal (riction adjusted) 7,431,153

Total economic burden (riction adjusted) 11,998,465

*Future ear coute u a aual rate o 3.5%.



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Cob all the healthcare cot ue to cacer,

the total cot to the nHs wa 3,582 llo.

iclu prvate healthcare expeture o cacer,

the total cot to the healthcare te woulcreae to 3,996 llo.

4.2.3 Informal care costs

A total o 142 llo hour o oral care wa

prove b re a relatve o the cacer

patet whlt the were recev treatet or

pallatve care. Approxatel 41% (59 llo hour)

o th care wa prove b ecoocall actve a

eploe relatve/re, wth the ajort o care

(83 llo hour) be prove b retre, actve

or ueploe oral carer. Cobe, the totalaual cot o oral care-v were etate

at 1,267 llo (Table 6).

4.2.4 Productivity costs

A total o 159,520 eath were retere wth

cacer a the a caue o eath, o whch 55,494

(35%) occurre patet uer the ae o 70

ear. Th reulte a etate lo o 646,102

work ear lot, reult a aual cot o

7,769 llo whe uture oreoe ear were

ot coute, a 5,740 llo ater cout

uture ear (Table 6). i ato, a etate

14 llo a o work were lot ue to cke

abece or capact relate wth cacer. Th

repreete a cot o 1,445 llo that whe

ajute b the rcto pero reulte a cot o

jut uer 424 llo.

Overall, cacer wa ou to cot 12 bllo

ter o health a ocal care, oral care a

prouctvt loe 2008. O thee cot, 33%

were ue to healthcare, 5% to ocal care a 11%to oral care, wth 51% o total cot be

accoute or b prouctvt loe.

4.3 COST COMPARISONS ACROSS DISEASES

The ocetal cot o eeta a cacer were

copare to each other a alo to the cot

o CHd a troke. The cot o the latter two

eae were erve ro prevou tue,13-16

whch ue lar etho a ource o

orato, a whoe cot reult were upate to

2008 prce.

Figure 1 Health a ocal care cot

Althouh eeta ha the lowet healthcare cot(Fure 1), 1.2 bllo, copare to 4.0 bllo or

cacer, 2.2 bllo or CHd, a 1.6 bllo or

troke, the cot place o the ocal care te

(9.1 bllo), ar outwehe the ocal care cot o

cacer, CHd a troke. Cob the cot to the

UK health a ocal ervce, eeta cot 10.3

bllo 2008, copare to 4.5 bllo or cacer,

2.7 bllo or troke a 2.3 bllo or CHd,

repreet a rect cot to each cte o 168 or

eeta, 74 or cacer, 44 or troke a 38

or CHd. U UK prevalece etate or thee

our eae, the health a ocal care cot per

pero wth the eae were evaluate at 12,521

or eeta, 2,559 or troke, 2,283 or cacer,

a 1,019 or CHd.

Table 7 Total cot b eae

Disease Health and social Total cost,

care costs, million million

deeta 10,291 22,723

Cacer 4,567 11,998

CHd 2,314 7,848

stroke 2,671 4,997

= socal care = Health care

Healtha

ndsocialcarecostsmillion

0

2,000

4,000

6,000

8,000

10,000

12,000

deeta

A

A B

A

A A

B

B

BB

Cacer CHd stroke


26/38

24

i ter o health a ocal care, oral care a

prouctvt loe, eeta ha the hhet cot

at earl 23 bllo (Table 7), ollowe b cacer

(12 bllo), CHd (8 bllo) a troke (5 bllo).Fure 2 how how thee cot were trbute

aot health, ocal a oral care, a

prouctvt loe.

For eeta, 55% o total cot were attrbutable to

oral care, 40% to ocal care a 5% to health

care (Fure 2). Prouctvt loe or th eae

were alot elble. i cotrat, or cacer hal o

all total cot o the eae were ue to prouctvt

loe (al ortalt loe), wth oral a

ocal care ol accout or 16% o total cot.

For both troke a CHd, total cot were ore

evel trbute acro the eret cateore

o cot. stroke wa the ol eae or whch

health a ocal care cot accoute or over 50%

o total cot.

Figure 2 dtrbuto o cot b eae

SECTION 5

RESULTS: RESEARCH FUNDING

5.1 SAMPLE

5.1.1 Governmental agencies

A total o 8 overetal aece u

health reearch were ete. Thee clue

4 reearch coucl a 4 reearch aece

ro the departet o Health a t evolve

atrato:

the mecal Reearch Coucl (mRC);

the Botecholo & Bolocal scece

Reearch Coucl (BBsRC);

the Ecooc & socal Reearch Coucl

(EsRC);

the Eeer & Phcal scece Reearch

Coucl (EPsRC);

the natoal ittute or Health Reearch (niHR);

the Reearch a developet Oce or the

norther irela Health a Peroal socal

servce;

the scotth Executve Health departet Che

scett Oce; a

the Wale Oce o Reearch a developet

or Health a socal Care.

iorato o the level o reearch u or

the cal ear 2007/2008 or eeta, cacer,

CHd a troke were obtae or 7 o the 8

overetal aece ete, wth ol the

Wale Oce o Reearch a developet al to

repo to our requet or orato.

5.1.2 Charities

Charte ete throuh the Ela & Wale

Chart Coo

A total o 6,751 charte were retere b the

Chart Coo a be actve the mecal

/ Health / scke area a prov oetar

u ether b ak rat to oraato or

poor or uertak reearch. due to the

ver hh uber o charte ete u th

earch crtera (=6,751), charte were rake

ter o ther aual coe a ol the rt two

hure charte, whch ha a cobe coe o

over 75% o the total, were coere. O the 200

charte, 36 (18%) were clue the aal.

Reao or exclu the rea 164 charte

are reporte Table 8.

CHd Cacer

deeta stroke

27% 2% 23% 18% 30%

5% 40% 55%


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25

Table 8 Reao or excluo o charte ete

throuh the Chart Coo

Reao or excluo nuber (%)

no health reearch u 74* (45%)

no reearch u eae

o teret 51 (31%)

Fue eerc health reearch 22 (13%)

Roal Collee 8 (5%)

Part o aother ber chart 3 (2%)

Cotacte or orato, but ale to repl 2 (1%)

Ol ue reearch ratructure 2 (1%)

Uvert 1 (


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26

Reearch u to cacer, CHd, eeta

a troke ro the 7 overetal aece

clue the aal aoute to 405

llo, lhtl le tha the total uae avalable b charte. Aa, cacer

wa the eae area recev ot u

(Table 9), 267 llo, ollowe b CHd (84

llo), eeta (36 llo) a troke

(18 llo). Althouh, a a proporto o

total reearch u to the our eae,

overetal aece evote ore

reearch u to eeta a troke

tha charte (Fure 3), cacer tll accoute

or 66% o all overet reearch u.

Table 10 Reearch u, uber o cae a total cot o eae

Cancer CHD Dementia Stroke

Total reearch u, thoua 590,411 169,260 50,244 23,355

Total uber o cae, thoua 2,000 2,271 822 1,044

Fu per cae 295 75 61 22

Total health a ocal care, l lo 4,567 2,314 10,291 2,671

Fu per 1 llo eae cot 129,269 73,153 4,882 8,745

Prevalece o cacer wa obtae ro Cacer Reearch UK tattc.85 Prevalece o troke a CHd

SECTION 6

DISCUSSION

Reult ro th report howe that the health care,

ocal care, oral care a prouctvt cot o

eeta were earl 23 bllo a ear. Over 55%

(12 bllo) o thee total cot wa ue to oral

care, repreet 1.5 bllo hour o upa care

prove b relatve a re o eetapatet. Lo ter ttutoalato cot

repreete 40% (9 bllo) o the total aual cot

wth a etate 304,850 patet care hoe.

Coverel, the cot to the nHs were coparabl

low accout or jut over 1 bllo, ot o whch

wa ue to overht ta hoptal (42%). due

to the late oet o eeta ot cae, the

prouctvt loe ue to orbt or ortalt

were ver low (le tha 1%).

The report alo cor the ao ap betweethe expecte uber o eeta cae a the

uber o patet wth eeta gP reter.

For exaple, Ela ol a etate 31% o

people wth eeta are retere gP lt.11 A

uber o reao have bee propoe or the low

rate o ao prar care ett,clu

gP lack o tra a coece ao

eeta a cue a recet natoal Aut

Oce report.8 i earl 2009, the natoal deeta

strate or Ela wa publhe orer to

help are thee cocer a rae awareeabout the ee o people wth eeta a ther

carer.11

A uber o prevoul publhe tue have alo

evaluate the cot o eeta or the UK.5;82 i

2006, the total cot o eeta wa etate at

approxatel 17 bllo per ear.5 Thee cot

were erve ro a Loo-bae tu o 132

people wth eeta ollowe betwee 1997 a

1999,30 whch were the upate to 2005/06 prce

level a extrapolate to the whole o the UK u

eeta prevalece etate erve ro expert

opo. i our tu we ou the cot o eeta

Chart goveret Total

76% 20% 3% 1% 66% 21% 9% 4% 71% 20% 6% 3%

Cacer CHd deeta stroke

Figure 3 Proporto o reearch u b eae area



29/38

27

to be approxatel 5 bllo ore at 23 bllo

or the ear 2008. Thee erece cot were

larel explae b the eret prevalece rate

a ethoolocal approache ue to etatethe cot. so, or exaple, whe prevalece rate

obtae ro the expert pael Kapp a Prce

(2007)5 were ue the etvt aal o th

tu the total cot o eeta ecreae ro

23 bllo to 20 bllo. neverthele, rearle

o the ethoolocal approach ue, the total cot

o eeta the UK ar outwehe the cot o

cacer, CHd a troke.

i orer to copare the ecooc bure o

eret eae, the cot aocate wth each

eae ut be etate u the ae etho

a aaltc raework. The etho ue to

evaluate the cot o eeta th report were

lar to prevou approache ue to etate

the ecooc bure o carovacular eae

(CVd), coroar heart eae (CHd) a troke

the Europea Uo a the UK.13-16 Ater upat

the reult ro thee tue to 2008 prce, a

rect coparo wa ae betwee the cot

o eeta wth thoe o CHd a troke wthout

cocer that the etate varato cot waattrbutable to the ue o eret ethooloe. i

ato, u the ae ethoolo, we etate

the ecooc o bure o cacer a o other

coparable etate were avalable or the UK.

stroke a eeta were aocate wth relatvel

low cot to the health care te (1.6 bllo

a 1.2 bllo, repectvel) whe copare to

cacer (4 bllo) a CHd (2.2 bllo). However,

wth hh rate o lo-ter ttutoalato,

eeta eerate cot to the ocal care te

o 9 bllo per ear, copare to 1 bllo or

troke, 0.5 bllo or cacer a 0.1 bllo or

CHd. Whe cot other tha health a ocal care

were coere, uch a oral care cot a

prouctvt loe, eeta wa aa etate

to have the hhet cot o all our eae

(approxatel 23 bllo), whch wa alot twce

the cot o cacer, three te that o CHd a over

4 te that o troke.

However, the a o a cot-o-lle tu ot

to uet how uch the UK houl pe o a

partcular eae. Our a wa ot to etate the

bure o eae o UK gro doetc Prouct

(gdP): or exaple, we ot clue all the cot

a traer paet aocate wth each o

the eae uch a hoe care, ocal ervceuch a eal o wheel a a care cetre,

peo a other ocal beet. Oe o the a

a o a cot-o-lle tue to help otor

polc tatve a to or eco o the

trbuto o reearch eort. Th cotet

wth a recet overetal revew to how publc

boe houl taret ecal reearch u.

The revew recoee that a aeet o

the pact o eae o the UK populato a

ecoo wa ecear to or the UK health

reearch prorte.17 Thereore, ater etat the

cot o cacer, CHd, eeta a troke we alo

evaluate the lk betwee the pact o thee our

eae a the allocato o reearch u b

charte a overetal oraato.

The reult o th report hhl ht that, cotrar

to the etate o the ecooc bure o

eae, reearch u hhl oate b

cacer ollowe a lo wa beh b CHd. Our

reult, le wth thoe ro prevoul publhe

tue, uet that both eeta a trokeare rol uerue whe copare to ther

prevalece a, epecall, ther health a ocal

care cot.77;78;82 Out o 833 llo reearch u

ae avalable b charte a overetal

oraato or cacer, CHd, troke a eeta

reearch, 71% wa evote to cacer reearch,

20% wa evote to CHd, 6% wa evote

to eeta a 4% to troke. Copar the

ecooc bure o thee our eae wth the

aout o reearch u receve, reult o

our tu how that or ever 1 llo health

a ocal care cot, cacer receve 129,269

reearch u, CHd receve 73,153, ollowe

b troke wth 8,745 a all eeta wth

4,882.

Poble reao or the ueru o both

troke a eeta coul be that both troke a

eeta are tll larel perceve a utreatable

eae, whch are cult to reearch a occur

al the elerl populato.77;78 Cotrar to

cacer a CHd, troke otl treate b

eeralt octor whle there tll o teratoal


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28

coeu about whch ecal pecalt houl

aoe a treat eeta.77 Th atttue towar

care o eeta a troke patet a haper

the reearch tatve o health proeoalappl or u.78 A how our reult, cacer

reearch u b charte receve a eve

reater proporto o total u tha troke, CHd

a eeta whe copare to overetal

u. Th pobl refect a publc preerece

towar CHd a cacer charte. it uclear wh

th happe, but ae, wth a percepto that

eeta a troke are coe to the ver elerl,

ha bee orware a a poble explaato.77;78

Refect the htorcall low vetet

eeta reearch, there are worrl ew ata

o epeolocal charactertc a ue o health

a ocal ervce b people wth eeta. Th

lack o hh qualt ata ake tue uch a

th ore cult to couct. The lat populato

bae tu to etate the prevalece o eeta

the UK wa perore over 17 ear ao.83;84

The EUROdEm prevalece rate were obtae

ro 1980-1990 prevalece tue acro

Europe.23 more recet etate o the prevalece

o eeta, uch a that b Kapp a Prce(2007),5 were bae olel o expert opo. i

th report, we ue the EUROdEm eta-aal

prevalece rate a the baele o our cot

etato a copare t wth the reult o u

the recet expert opo rate etate Kapp

a Prce (2007).5

i ato, there are o curretl publhe lare

UK bae tue ollow cohort o patet

wth eeta a ther carer to or o ther

health a ocal care uae. The tue that areavalable have eerall all aple e a

repreet level o care over 10 ear ao.28;30

naturall, th lkel to aect the preco o our

etate o the cot o prar care, outpatet,

a accet a eerec ue our aal,

a etate prevou tue uch a b Kapp

a Prce (2007).5 Furtherore, a the tue

ue to evaluate prar, outpatet a eerec

care uae were bae o patet aoe wth

eeta, our tu we ae the aupto that

uaoe patet woul have lar patter

o reource uae: th a ot be the cae

practce.

Aother ltato o our tu that we ot

clue all the cot aocate wth the our

eae uer queto. Frt, the pact o eae

o oral carer wa olel evaluate a theopportut o upa care. We ot accout

or a health a ocal ervce uae relate

to the atoal ea o car or oeoe.

seco, ue to the pauct o ata a orer to

copare the cot etate wth thoe ue to CHd,

troke a cacer, oe ocal care cot, uch a

hoe a a care a eal o wheel, were ot

clue the aal. neverthele, the a cot

rver o health a ocal care eeta patet

were clue the aal, wth the otte cot

be a relatvel all proporto o total cot.28;30

The ltato o our revew o the level o reearch

u allocate b charte a overetal

oraato to cacer, troke, CHd a eeta

houl alo be ackowlee. A wth other tue

evaluat level o reearch u or eret

eae,76-79 our tu houl be vewe a v

a etate o the proporto o reearch u

allocate to each eae, but ot ecearl

refect the total aout o u.

Frt, we ot clue u ro all the

charte retere the UK, wth our aal

be retrcte to charte the Aocato or

mecal Reearch Charte (AmRC), a to the top

200 health-relate charte, ter o coe,

retere wth the Ela a Wale Chart

Coo.

seco, charte retere olel scotla or

norther irela were ete ol throuh the

AmRC, a the chart reter or scotla a

norther irela ot cota ucet etal to

et relevat charte. However, out o the 116

charte the AmRC, ol 4 (3%) a 2 (2%) were

retere olel scotla or norther irela,

repectvel, refect the act that ot o the

charte u ecal reearch are retere

Ela a Wale.

Thr, althouh we our upot to avo ouble-

cout reearch u, charte clue the

tu coul potetall ake rat to each other

a th coul ot alwa be ete aualreport a accout.



31/38

29

Fourthl, oe relevat reearch u boe

were ot clue the aal. We were uable

to obta a orato o the level o reearch

u allocate b the Wale Oce o Reearch& developet, a ve charte ether reue to

partcpate or ot repo to our requet or

orato. However, t ulkel that the cluo

o the reearch u ae avalable b thee

oraato woul chae the relatve level o

reearch u acro the our eae.

Fall, a the tu b Pelebur et al. (2004) 78

we ot clue bac cece reearch u,

a uch bac cece reearch potetall

relevat to a eae area rather tha a le

eae. However, thee ltato are ulkel

to ba a eae area partcular, a a a

reult wll ot alter the we parte o u

oberve.

i cocluo, eeta create a cat bure

al throuh the cot place o upa carer

a lo-ter ttutoale care. The cot

aocate wth eeta are coerabl hher

tha thoe o cacer, CHd or troke. Prevou

tue evaluat level o reearch u have

uete that reearch to both eeta a

troke everel uerue. Th report trol

cor that u up-to-ate ata, a

how that reearch o eeta a troke

rea rol uerue whe copare to

cacer a CHd.

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