Objectives: Patients with Parkinson's disease (PD) experience an onset of motor and/ or non-motor symptoms (MS; NMS), including slowed movement, resting tremor, gait and balance problems; anxiety, depression and cognitive impairment. The economic burden associated with PD is considerable, but little is known about the cost engendered by the presence of NMS, which are often treated as peripheral issues to MS. We evaluated healthcare resource utilization (HRU) among real-world PD patients with motor-only (MO) and motor plus non-motor (MNM) symptoms. Methods: Data analysed were captured in the 2017 Adelphi Parkinson's Disease Specific Programme, a point-in-time observational study of 109 neurologists and their consulting PD patients of all disease stages in the US. Patients were separated into two groups for analysis: MO patients and MNM patients, then propensity-score matched for age, sex, BMI, quantities of both motor and non-motor comorbidities and current Hoehn & Yahr severity. The groups were then compared for differences in HRU costs arising from physician-recorded consultations, hospitalisations and treatment related to PD in the last 12 months. Results: From a population of 1,409 PD patients, physician-reported data for 383 MO and 1,019 MNM entered the propensity-score matching analysis. Over the 12 months preceding the most recent consultation, the mean PD-related HRU costs (US Dollars

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Data on the economic burden associated with tuberous sclerosis complex (TSC) among patients with epilepsy in the United States (US) are limited. This study aimed to assess all-cause and epilepsy-related healthcare resource utilization (HRU) and healthcare costs in the US among patients with epilepsy and TSC compared with patients with epilepsy but without TSC. Methods: This retrospective study was conducted using the Symphony Health Solutions claims database (April 1, 2017-June 30, 2019. Patients with ≥1 medical claim with a diagnosis code representing epilepsy or seizures were assigned to the cohort with TSC if they had ≥1 medical claim for TSC; the remaining patients were assigned to the cohort without TSC. Patients in the cohort with TSC were exactly matched 1:5 on demographics to patients in the cohort without TSC. All-cause and epilepsy-related HRU, medical charges, prescription drug costs, and the use of antiepileptic drugs (AEDs) were compared between the matched cohorts over the 1-year study period. Results: A total of 2028 patients with epilepsy and TSC were matched to 10,140 patients with epilepsy but without TSC. Patients with TSC were more likely to have a diagnosis code for refractory epilepsy (38.7% vs. 10.2%, p < 0.001) and more likely to have used an AED (89.5% vs. 71.2%, p < 0.001) than patients without TSC over the study period. On average, patients with TSC received 2.1 distinct AEDs versus 1.3 distinct AEDs among patients without TSC. Compared with patients without TSC, patients with TSC had numerically but not statistically higher incidence rates of all-cause outpatient, clinic, office, and other visits; significantly lower rates of all-cause inpatient and emergency room visits (p < 0.001); and statistically significantly higher incidence rates of epilepsy-related outpatient, inpatient, office, and other visits (p ≤ 0.001). All-cause prescription drug costs were significantly higher among patients with TSC than patients without TSC (cost difference per patient: $14,179, p < 0.001). All-cause medical service charges were numerically higher for patients with TSC, but the differences were not statistically significant (charge difference per patient: $4293 for medical services, p = 0.707). Epilepsy-related costs were significantly higher for patients with TSC; the cost difference per patient was $14,639 for prescription costs (p < 0.001), and the charge difference per patient was $16,838 for medical charges (p = 0.019). Conclusion:The results of this study underscore the high epilepsy-related HRU and costs incurred by patients with epilepsy and TSC relative to those incurred by patients with epilepsy but without TSC.

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