The art of cost of illness.

The worldwide costs of dementia are US$315 billion [1]. Monthly costs of Alzheimer’s disease in Spain are 1,426 per month [2]. What is the purpose, value, and usefulness of such statements? The number of Cost of Illness (CoI) studies is steadily increasing. For almost any high resource-consuming disease, there is some kind of CoI estimate available. There is also a kind of ongoing CoI rally. Like kids in the sandbox, advocates for one disease argue that “my disease is much more expensive than your disease”, implicitly saying that a higher CoI demands more resources (than diseases with lower CoI). Any health economist knows that this way of arguing is a misuse. But, so what; politicians and other decision makers in the allocation of resources are very sensitive to such policy-making statements. In a time when resources for care and research are scarce (which they of course always more or less will be!), perhaps not all, but many tricks seems to be defensible – “the end justifies the means”! Behind any message there is an interest and a more or less hidden messenger – a drug company, a patient advocate organization/non-governmental organization (NGO), a research group looking for funding, etc. Chastened economists also sarcastically say that if all CoI figures for various disorders are summarized, this