Costs of Parkinson’s Disease and Antiparkinsonian Pharmacotherapy: An Italian Cohort Study

Abstract

Objective: Antiparkinsonian pharmacotherapy is costly and the determinants of drug costs in Parkinson’s disease (PD) have been poorly investigated. The objective of this study was to investigate the costs of PD and antiparkinsonian drugs in an Italian cohort of patients and identify cost-driving factors of drug therapy. Methods: Seventy outpatients with idiopathic PD were recruited in the Department of Neurology, Napoli University, Italy. Data on resource utilization were collected for 6 months using a bottom-up approach. Clinical status was evaluated using the Unified Parkinson’s Disease Rating Scale. Direct and indirect costs were calculated from the societal perspective (figures of year 2009). Independent determinants of total costs and costs of antiparkinsonian drugs were identified using multivariate regression analysis. Results: The total costs of PD were EUR 8,640 (95% CI: EUR 6,700–11,240) per patient over a 6-month period. Direct costs accounted for 70% of the total costs. Antiparkinsonian drugs (EUR 1,450; 95% CI: EUR 1,220–1,760) were the primary component of costs paid by the health insurance (39.6%) and one of the most expensive components of the direct costs (24.0%). The highest copayments made by patients were for antiparkinsonian drugs and medical equipment (58%). Independent determinants of the increased costs of antiparkinsonian pharmacotherapy were younger age and occurrence of motor fluctuations. Conclusions: Antiparkinsonian pharmacotherapy is one of the major cost components of PD-related costs for health insurance. It imposes a considerable economic burden on patients and their families as well.

Cost-of-illness in multiple system atrophy and progressive supranuclear palsy

“…The total costs of idiopathic PD (EUR 10,050/6 months) in a recently published German longitudinal study were approximately 40% lower than the total costs in the current study (EUR 16,670/ 6 months) [32]. Costs of PD in other studies from Western European countries were about 40-50% lower in comparison to the costs of APS in our study [10,13,28,37]. Distribution between direct and indirect costs in APS and PD are similar, although the total costs per individual are higher for APS compared to PD.…”

“…Distribution between direct and indirect costs in APS and PD are similar, although the total costs per individual are higher for APS compared to PD. The direct costs in APS and PD account for approximately 65-75% of total costs [32,36,37]. Another common pattern of cost distribution in PD and APS is the relation between costs for inpatient care and costs for outpatient care.…”

Systematic Review and Critical Analysis of Cost Studies Associated with Parkinson’s Disease

“…In one of the studies [20], however, indirect costs were only considered, from the perspective of insurance companies and human capital, whereas, in another [21], the aim was to evaluate intangible costs alone through lost years of life. Similarly, three studies concentrated only on medication costs [25, 30, 31]. …”

Ablative surgery for Parkinson’s disease: Is there still a role for pallidotomy in the deep brain stimulation era?

“…When analyzing studies from six different countries (Germany, Austria, Portugal, Italy, Russia and Czech Republic), it is possible to observe that all of them resulted in high costs of the illness, with mean values of the total costs that ranged from €2620 (Russia) to €9820 (Austria) in a 6-months period [72][73][74][75][76]. Although there is a wide variation in these values, they all showed a direct relation between the severity of the disease and the costs generated by it.…”