O2-04-06: The growing macroeconomic burden of Alzheimer's disease in China

Over the coming 40 years China will exhibit a large proportional decrease in working age individuals and an increase in retirement-age workers and elderly people. Since Alzheimer's Disease (AD) primarily affects the over 60’s it is hypothesised that currently significant AD mortality, morbidity and care burdens on China's working population are set to accelerate. Previous AD burden studies estimate microeconomic costs, omitting the wider macroeconomic impacts, and only partially capturing the potential benefits of investment and research into treatment, care and mitigation of AD. Prevalence, morbidity (Years Lived with Disability) and mortality (Years of Life Lost) were estimated using a two-stage microsimulation progression model for AD. Caregiver time (formal and informal) and costs (care and non-care) for AD were based on published estimates. Both health and care impacts on the labour force were adjusted by participation rates. Subsequent AD costs and labour supply effects for 2011-2050 were imposed on a dynamically recursive Computable General Equilibrium simulation model of the Chinese Economy. Sensitivity to both economic and AD model parameter assumptions were quantified. 2011-2050 Chinese AD prevalence increased from ∼6mn to ∼28mn and AD-related workforce reductions increased from ∼0.40% to ∼1.15%. Conservative baseline macroeconomic estimates (tabulated) suggest elimination of AD increases the cumulative Net Present Value of China's Gross Domestic Product (GDP) by US$8tr (1.25%). Annual GDP impacts grow exponentially exceeding US$1tr by 2050 (2011 prices). The annual GDP per capita burden is US$255 (1%). Morbidity impacts exceed mortality effects whilst medical costs (31%) constitute the largest impact share. Results are insensitive to AD parameters but less conservative discount rates increase burden estimates. AD is likely to have a significant impact on the Chinese economy, representing one quarter of China's health budget in 2011-2050. Furthermore, the 2050 Chinese burden figure is comparable to the microeconomic cost of illness-based 2050 prediction for the US. Chinese policy makers should address this burden urgently, to maintain both Chinese citizen welfare and society-wide economic prosperity. It is clear that these dynamics are not limited to China and the global community should develop action plans to counter this fast growing socioeconomic burden.