Journal of Autism and Developmental Disorders

, Volume 38, Issue 3, pp 546–552 | Cite as

Medical Expenditures for Children with an Autism Spectrum Disorder in a Privately Insured Population

  • Tom T. ShimabukuroEmail author
  • Scott D. Grosse
  • Catherine Rice
Original Paper


This study provides estimates of medical expenditures for a subset of children and adolescents who receive employer-based health insurance and have a medical diagnosis of an autism spectrum disorder (ASD). Data analyzed were from the 2003 MarketScan® research databases. Individuals with an ASD had average medical expenditures that exceeded those without an ASD by $4,110–$6,200 per year. On average, medical expenditures for individuals with an ASD were 4.1–6.2 times greater than for those without an ASD. Differences in median expenditures ranged from $2,240 to $3,360 per year with median expenditures 8.4–9.5 times greater. These findings add to a growing body of evidence that children and adolescents with medical diagnoses of an ASD incur elevated medical utilization and costs.


Autism Autism spectrum disorders Medical expenditures Incremental cost Cost ratio 



We thank Noelle-Angelique Molinari, PhD, of the Centers for Disease Control and Prevention for her contributions to the manuscript. Disclaimer: The findings and conclusions are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.


  1. Aman, M. G., Lam, K. S., & Collier-Crespin, A. (2003). Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio. Journal of Autism and Developmental Disorders, 33, 527–534.PubMedCrossRefGoogle Scholar
  2. Centers for Disease Control, Prevention. (2006). Mental health in the United States: Parental report of diagnosed autism in children aged 4–17 years–United States, 2003–2004. Morbidity and Morality Weekly Report, 55, 481–486.Google Scholar
  3. Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118, e1203–e1211.PubMedCrossRefGoogle Scholar
  4. Ganz, M. L. (2006). The costs of autism. In S. O. Moldin, & J. L. R. Rubenstein (Eds.), Understanding autism: From basic neuroscience to treatment, 1st edn. (pp. 475–502). Boca Raton, FL: CRC Press.Google Scholar
  5. Gurney, J. G., McPheeters, M. L., & Davis, M. M. (2006). Parental report of health conditions and health care use among children with and without autism: National Survey of Children’s Health. Archives of Pediatrics & Adolescent Medicine, 160, 825–830.CrossRefGoogle Scholar
  6. Jarbrink, K., & Knapp, M. (2001). The economic impact of autism in Britain. Autism, 5, 7–22.PubMedCrossRefGoogle Scholar
  7. Langworthy-Lam, K. S., Aman, M. G., & Van Bourgondien, M. E. (2002). Prevalence and patterns of use of psychoactive medicines in individuals with autism in the Autism Society of North Carolina. Journal of Child and Adolescent Psychopharmacology, 12, 311–321.PubMedCrossRefGoogle Scholar
  8. Liptak, G. S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism: Data from U.S. national samples. Journal of Autism and Developmental Disorders, 36, 871–879.PubMedCrossRefGoogle Scholar
  9. Mandell, D. S., Cao, J., Ittenbach, R., & Pinto-Martin, J. (2006). Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. Journal of Autism and Developmental Disorders, 36, 475–485.PubMedCrossRefGoogle Scholar
  10. Martin, A., Scahill, L., Klin, A., & Volkmar, F.R. (1999). Higher-functioning pervasive developmental disorders: Rates and patterns of psychotropic drug use. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 923–931.CrossRefGoogle Scholar
  11. Newschaffer, C. J., & Curran, L. K. (2003). Autism: An emerging public health problem. Public Health Reports, 118, 393–399.PubMedGoogle Scholar
  12. Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 17, 348–355.PubMedCrossRefGoogle Scholar
  13. Ouyang, L., Grosse S. D., Armour, B. S., & Waitzman, N. J. (2007). Health care expenditures of children and adults with spina bifida in a privately insured U.S. population. Birth Defects Research Part A: Clinical and Molecular Teratology, 79, 552–558.CrossRefGoogle Scholar
  14. Peele, P. B., Lave, J. R., & Kelleher, K.J. (2002). Exclusions and limitations in children’s behavioral health care coverage. Psychiatric Services, 53, 591–594.PubMedCrossRefGoogle Scholar
  15. SAS Institute. (2004). SAS 9.1. Cary, NC: Author.Google Scholar
  16. Thompson Medstat. (2003). MarketScan® research databases user guide and database dictionary. Ann Arbor, MI: Author.Google Scholar
  17. Thompson Medstat. (2004). DataProbe® end user training. Ann Arbor, MI: Author.Google Scholar
  18. Wiggins, L. D., Biao, J., & Rice, C. (2006). Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample. Journal of Developmental & Behavioral Pediatrics, 27, S79–S87.CrossRefGoogle Scholar
  19. Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003). Prevalence of autism in a US metropolitan area. JAMA, 289, 49–55.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Tom T. Shimabukuro
    • 1
    Email author
  • Scott D. Grosse
    • 2
  • Catherine Rice
    • 2
  1. 1.Health Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaUSA
  2. 2.National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaUSA

Personalised recommendations