Scaling-up an evidence-based intervention for family carers of people with dementia: Current and future costs and outcomes

ObjectivesThe STrAtegies for RelaTives (START) intervention is effective and cost-effective in supporting family carers of people with dementia. It is currently not available to all eligible carers in England. What would be the impacts on service costs and carer health-related quality of life if START was provided to all eligible carers in England, currently and in future?MethodsEffectiveness and cost-effectiveness data from a previously conducted randomised controlled trial were combined with current and future projections of numbers of people with newly diagnosed dementia to estimate overall and component costs and health-related quality of life outcomes between 2015 (base year for projections) and 2040.ResultsScaling-up START requires investments increasing annually but would lead to significant savings in health and social care costs. Family carers of people with dementia would experience improvements in mental health and quality of life, with clinical effects lasting at least 6 years. Scaling up the START intervention to eligible carers was estimated to cost 9.4 pound million in 2020, but these costs would lead to annual savings of 68 pound million, and total annual quality-adjusted life year (QALY) gains of 1247. Although the costs of START would increase to 19.8 pound million in 2040, savings would rise to 142.7 pound million and Quality adjusted life years gained to 1883.ConclusionsScaling-up START for family carers of people with dementia in England would improve the lives of family carers and reduce public sector costs. Family carers play a vital part in dementia care; evidence-based interventions that help them to maintain this role, such as START, should be available across the country. Family carers are the mainstay of dementia support across the world.The STrAtegies for RelaTives (START) intervention has previously been shown to be clinically and cost-effective.Making START available to all eligible family carers in England, both currently and projected to 2040, would lead to significant savings in health and social care service costs, amounting to 143 pound million in 2040.Improvements in the mental health and quality of life of carers would also be substantial.