Costs of autism spectrum disorders and access to services in Spain

Background Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with significant impact on families and society. The objective of this article is to present the results of the first cost-of-illness study of ASD in Spain. Methods An observational, cross-sectional study was designed to estimate the annual cost per individual by means of an anonymous survey and a bottom-up approach to collect use of services and costs. A societal perspective was adopted, including direct costs related to education, health care, and social care sectors, and productivity loss. Results Complete responses of 334 individuals on the spectrum were obtained (mean age 12.3 years, 82% male, 46.4% with autistic disorder). The most used health care services were general practitioners (35.6%), accident and emergency services (15.3%), and community nurses (10.8%). Among specialized health care services, the most frequently used were psychologists, psychiatrists and other types of individual therapy. The most used drugs were antipsychotics. There was a variety of social services available and accessed. The most often reported service accessed by carers was additional visits to general practitioner (15%). The average annual direct cost of ASD in Spain was €10,974 per individual (95%CI 8717–13879). Logistic regression found that individuals with anxiety, intellectual disability, and an autistic disorder were more likely to access services. The average cost of productivity losses per carer was €2186.4. Conclusions The average annual direct cost of ASD in Spain was €10,974 per individual. Individuals with anxiety or intellectual disability co-occurring with autistic disorder were more likely to access services. Findings from this study would be useful to inform service planning and future research.