Mortality of Parkinson's disease by Hoehn–Yahr stage from community‐based and clinic series [Keelung Community‐based Integrated Screening (KCIS) no. 17)]

Liou, Horng-Huei; Wu, Chia Yun; Chiu, Yueh‐Hsia; Yen, Amy Ming Fang; Chen, Rong Chi; Chen, Ta Fu; Chen, Chih Chuan; Hwang, Yuarn Chung; Wen, Ying; Chen, Chien-Jen

doi:10.1111/j.1365-2753.2008.01041.x

Cited by 13 publications

(15 citation statements)

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“…In order to capture the effect of increased mortality risk for individuals with PD and the relationship between disease status and mortality, we used age-specific all-cause general population mortality rates from the UK [58], to which we applied relative risks within each H&Y stage to reflect increasing mortality risk with disease progression, using data from a community-based study [49]. …”

Section: Methodsmentioning

confidence: 99%

The cost-effectiveness of deep brain stimulation in combination with best medical therapy, versus best medical therapy alone, in advanced Parkinson’s disease

et al. 2013

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Parkinson’s disease (PD) is a complex progressive movement disorder leading to motor and non-motor symptoms that become increasingly debilitating as the disease advances, considerably reducing quality of life. Advanced treatment options include deep brain stimulation (DBS). While clinical effectiveness of DBS has been demonstrated in a number of randomised controlled trials (RCT), evidence on cost-effectiveness is limited. The cost-effectiveness of DBS combined with BMT, versus BMT alone, was evaluated from a UK payer perspective. Individual patient-level data on the effect of DBS on PD symptom progression from a large 6-month RCT were used to develop a Markov model representing clinical progression and capture treatment effect and costs. A 5-year time horizon was used, and an incremental cost-effectiveness ratio (ICER) was calculated in terms of cost per quality-adjusted life-years (QALY) and uncertainty assessed in deterministic sensitivity analyses. Total discounted costs in the DBS and BMT groups over 5 years were £68,970 and £48,243, respectively, with QALYs of 2.21 and 1.21, giving an incremental cost-effectiveness ratio of £20,678 per QALY gained. Utility weights in each health state and costs of on-going medication appear to be the key drivers of uncertainty in the model. The results suggest that DBS is a cost-effective intervention in patients with advanced PD who are eligible for surgery, providing good value for money to health care payers.

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Section: Methodsmentioning

confidence: 99%

The cost-effectiveness of deep brain stimulation in combination with best medical therapy, versus best medical therapy alone, in advanced Parkinson’s disease

et al. 2013

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“…Early detection and treatment of IPD may increase life expectancy . One study found that IPD cases detected early had a 51% lower incidence of Stage III or greater and 25% lower mortality . The results of the current study suggest that the active detection method identified more Stage I and II IPD cases (82.7%) than did the NHI claims records (52%, P = .003).…”

Section: Discussionmentioning

confidence: 50%

“…A previous study found that subjects in H‐Y Stage I may have the same life expectancy as the general population . Early detection and treatment of IPD may increase life expectancy .…”

Section: Discussionmentioning

confidence: 95%

Active and Passive Methods of Detecting Parkinson's Disease

Wen

Yen

Chiu

et al. 2015

J American Geriatrics Society

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speed was found to be directly correlated with SPMSQ (P = .002) after adjustment for blood pressure and eGFR. DISCUSSIONParticipants had many comorbidities and used many drugs an on average had mild cognitive impairment and slow gait speed. Nevertheless, they had an overall satisfactory compensation of hypertension. Participants with median clinic SBP less than 140 mmHg and orthostatic SBP less than 135 mmHg had poorer cognitive performance. Participants with greater cognitive decline were older and had slower gait speed and lower BP. Conversely, participants with better cognitive status had higher seated and orthostatic SBP, with the highest SBP detected being 160 mmHg. Hypertension is associated with white matter hyperintensities (WMHs), and WMHs may influence mobility, cognition, and mood, 8 although excessive reduction of BP promotes progression of brain WMHs and cognitive impairment. 9 These findings support the idea that BP values play a critical role in the association between slow gait speed and cognitive impairment in older adults with arterial hypertension. In very old adults, the target for BP should not be too strict, because of the negative effect of lower BP on cognitive function and mobility. Walking speed may be a useful way to identify elderly adults with arterial hypertension with poor prognosis. 10 Physicians who treat elderly adults with arterial hypertension should always assess gait speed and cognitive status using simple, validated, reliable, rapid, inexpensive tests.

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“…Probability of death was calculated from the US life tables 32 with an adjustment based on the relative risk of death given the patients' age and PD severity, informed by Liou et al 38 Mortality hazard ratios based on age and Hoehn and Yahr stage are shown in the Online Supplementary Material, Table S1.…”

Section: Mortality Inputsmentioning

confidence: 99%

Cost-Effectiveness of Apomorphine Sublingual Film as an "On-Demand" Treatment for "OFF" Episodes in Patients with Parkinson's Disease

Thach

Kirson

Zichlin

et al. 2021

JHEOR

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Background: “On-demand” treatments approved in the United States (US) for “OFF” episodes in Parkinson’s disease (PD) include apomorphine hydrochloride injection (SC-APO), apomorphine sublingual film (APL), and levodopa inhalation powder (CVT-301). APL received US approval in 2020, and its cost-effectiveness has not been compared with SC-APO and CVT-301. Objective: To develop a cost-effectiveness analysis model comparing APL versus SC-APO and CVT-301 for treatment of patients with PD experiencing “OFF” episodes from a US payer perspective. Methods: The model estimated total costs and effectiveness for each comparator arm, informed from the treatments’ pivotal studies or literature, over a 10-year horizon. Total and incremental patient costs (in 2020 US dollars), total time spent without “OFF” episode symptoms, and quality-adjusted life years (QALY) gained were summarized and compared. Incremental cost-effectiveness ratios for APL versus SC-APO and CVT-301 were estimated and expressed as incremental patient costs per patient QALY gained and incremental cost per “OFF” hour avoided. Scenario analyses varying inputs and including caregiver costs were also conducted. Results: In the base case, APL had the lowest total “on-demand” treatment costs ($42,095) compared with SC-APO ($276,320; difference: –$234,225) and CVT-301 ($69,577; difference: –$27,482) over the 10-year horizon. APL was also associated with the highest utility, with incremental QALYs of 0.019 versus SC-APO and 0.235 versus CVT-301. APL was dominant over CVT-301 in terms of incremental cost per “OFF” hour, and dominant over both CVT-301 and SC-APO in terms of incremental cost per QALY gained. In all scenario analyses, APL was dominant against both SC-APO and CVT-301, confirming the robustness of the base-case results. Discussion: APL was dominant compared with both comparator arms, being less costly and more effective on average than SC-APO and CVT-301 in terms of QALYs. For SC-APO, cost-effectiveness of APL was driven by lower “on-demand” treatment costs and adverse event–related disutilities. For CVT-301, cost-effectiveness of APL was driven by lower “on-demand” treatment costs and substantially higher efficacy. Conclusions: From a US payer perspective, APL represents a cost-effective option compared with SC-APO and CVT-301 for treatment of “OFF” episodes in patients with PD.

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Mortality of Parkinson's disease by Hoehn–Yahr stage from community‐based and clinic series [Keelung Community‐based Integrated Screening (KCIS) no. 17)]

Abstract: The present study revealed that early detection of PD through a community-based survey may reduce 51% incidence of stage III or more severe PD at diagnosis, leading to a 25% reduction in mortality.

Cited by 13 publications

References 14 publications

The cost-effectiveness of deep brain stimulation in combination with best medical therapy, versus best medical therapy alone, in advanced Parkinson’s disease

The cost-effectiveness of deep brain stimulation in combination with best medical therapy, versus best medical therapy alone, in advanced Parkinson’s disease

Active and Passive Methods of Detecting Parkinson's Disease

Cost-Effectiveness of Apomorphine Sublingual Film as an "On-Demand" Treatment for "OFF" Episodes in Patients with Parkinson's Disease

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