The Economic Cost of Adults with Autism Spectrum Disorder on Households

Background: In 2010, 1 in 68 children had been diagnosed with an Autism Spectrum Disorder (ASD), an increase of 120 percent in prevalence since 2000.  As larger cohorts age and transition to adulthood, ASD will impose a greater economic burden on households.  Few studies in the field have assessed the cost of ASD in adults, and even fewer have focused on the cost from a household perspective.

Objectives: The objective of this study was to produce preliminary estimates of the direct and indirect cost of ASD in adults from a household perspective.

Methods: We developed a survey instrument to gather data from households on the economic cost of caring for adults with ASD.  We recruited 31 households in the South Florida area to participate in the study, and asked the household primary caregiver to complete the survey.  The survey instrument was designed to match the Medical Expenditures Panel Survey (MEPS) database.  Each adult with ASD from our study was matched to one or more adults without ASD from MEPS using the nearest neighbor matching method.  The direct medical cost of ASD, defined as the additional cost of caring for adults with ASD compared to similar adults without ASD, was estimated with a generalized linear model to account for skewness in the MEPS cost data.  Other direct costs (accommodations and other non-medical services) as well as indirect costs (productivity loss of the primary caregiver and the adult with ASD) were obtained from the survey.

Results: The average total economic cost of ASD in adults for households in our study was estimated at $42,684 annually (in 2015 dollars).  Income loss from the primary caregiver ($11,665) and adult with ASD ($25,308) accounted for the majority of the cost.  Direct medical costs for outpatient, emergency room, hospital stays, and dentist services were $554 annually.  Direct non-medical costs for accommodation, paid helper, special needs school, speech therapy, occupational therapy, and vocational rehabilitation for the adult with ASD were $8,485 annually.  Adults with ASD had 4.4 more outpatient visits and 1.0 more hospital visit per year than adults without ASD.

Conclusions: This is, to our knowledge, the first study to estimate the cost of ASD in adults in the U.S.  We estimated the cost of ASD in adults for an average household in South Florida at $42,684.  This translates to a total economic cost to households in Florida of $663 million per year and $21 billion nationwide.