BACKGROUND:There is paucity in the level of knowledge on the actual insurer expenses associated with patients suffering with dementia in the developing world. Less is known about direct costs by severity and how costs vary because of the presence of other comorbidities. METHODS:Using claims data from an insurer for three years, we identified patients with AD with an algorithm that takes advantage of information on age, primary diagnosis, and services and drugs provided. RESULTS:Distribution by dementia stage was as follows: mild 21%, moderate 53%, severe 17%, and undetermined 9%. Expenses paid for all causes by the insurer were at least double than estimated in the literature and were increasing annually at rates higher than 30%. Also, 92% of patients have at least another chronic condition. CONCLUSIONS:Worldwide costs of dementia estimates maybe underestimating the actual costs to health systems in the developing world.