There are some studies estimating the costs in Brazil. According to a cross-sectional study conducted with people living with dementia who attended an outpatient health care in a hospital in São Paulo, dementia direct and indirect costs were US$1,012.35, US$1,683.18, and US$1,372.30 per patient/month, respectively, for mild, moderate, and severe stages of dementia. These included the unpaid care costs, expenditures with transport, diapers, medication, use of emergency services, health insurance, hospital stay, etc. (Ferretti et al., 2018). Using a similar list of variables a study conducted with 93 caregivers being followed up by an outpatient clinic from the University of São Paulo Clinical Hospital, calculated a total monthly indirect care cost of US$1,122.40, US$1,508.90, and US$1,644.70, for mild, moderate, and severe stages of dementia, respectively (Ferretti et al., 2015). Another study revealed that R$90,108,885.14 (US$22,860,464.56) were spent with medication to Alzheimer’s disease by the Brazilian Unified Health System (SUS) between 2008 and 2013 (Costa et al., 2015). A more recent study conducted a cost-effectiveness analysis from the SUS perspective between donepezil and rivastigmine therapy for mild and moderate Alzheimer’s disease (AD). The study showed the annual cost (in Brazilian reais) for donepezil is 30,556.45 and for rivastigmine is 32,685.77. According to the current Brazilian clinical guidelines for AD, it is estimated that rivastigmine is less cost-effective (0.39 QUALY/32,685.77 Brazilian reais) than donepezil (da Silva et al., 2018).

References:

Costa, R. D. F. da, Osorio-de-Castro, C. G. S., Silva, R. M. da, Maia, A. de A., Ramos, M. de C. B., & Caetano, R. (2015). Aquisição de medicamentos para a Doença de Alzheimer no Brasil: Uma análise no sistema federal de compras, 2008 a 2013. Ciência & Saúde Coletiva, 20(12), 3827–3838. https://doi.org/10.1590/1413-812320152012.11542015

da Silva, L. R., Vianna, C. M. M., Mosegui, G. B. G., Peregrino, A. A. F., Marinho, V., & Laks, J. (2018). Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil. Revista Brasileira de Psiquiatria, 41(3), 218–224. https://doi.org/10.1590/1516-4446-2017-0021

Ferretti, C., Nitrini, R., & Brucki, S. M. D. (2015). Indirect cost with dementia. A Brazilian study. Dementia & Neuropsychologia, 9(1), 42–50. https://doi.org/DOI:10.1590/S1980-57642015DN91000007

Ferretti, C., Sarti, F. M., Nitrini, R., Ferreira, F. F., & Brucki, S. M. D. (2018). An assessment of direct and indirect costs of dementia in Brazil. PLoS ONE, 13(3). https://doi.org/10.1371/journal.pone.0193209