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A Multicountry Updated Assessment of the Economic Impact of Fetal Alcohol Spectrum Disorder

Costs for Children and Adults

Greenmyer, Jacob R., BS; Klug, Marilyn G., PhD; Kambeitz, Cassondra, BS; Popova, Svetlana, MD; Burd, Larry, PhD

doi: 10.1097/ADM.0000000000000438
Original Research

Aim: To conduct a systematic review and quantitative analysis of the world literature on the economic impact of fetal alcohol spectrum disorder (FASD).

Methods: A comprehensive literature review was conducted using multiple electronic databases and reference materials.

Results: Thirty-two studies from 4 countries met the inclusion criteria (United States [n = 20], Canada [n = 9], Sweden [n = 2], and New Zealand [n = 1]). The studies reported the economic impact of FASD on health care, special education, residential care, criminal justice system, productivity losses due to morbidity and premature mortality, productivity losses of caregivers of children with FASD, and intangible costs. The economic estimates vary considerably due to the different methodologies used by different studies. The mean annual cost for children with FASD was estimated to be $22,810 and for adults $24,308. Residential costs for children with FASD were 4-fold greater than for adults with FASD. The costs of lost productivity for adults were 6.3-fold greater than for children.

Conclusions: The data on the economic burden of FASD are scarce, and the existing estimates likely underestimate the full economic impact of this disorder on the affected individuals, their caregivers, and society. However, the current research is sufficient to demonstrate that FASD is a serious public health problem associated with tremendous economic burden.

University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.

Send correspondence to Larry Burd, PhD, Director, North Dakota Fetal Alcohol Syndrome Center, University of North Dakota School of Medicine and Health Sciences, 1301 N Columbia Rd Stop 9037, ND. E-mail:

Received 3 January, 2018

Accepted 25 June, 2018

The authors have no conflicts of interest to disclose.

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© 2018 American Society of Addiction Medicine