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An economic model of Parkinson's disease: Implications for slowing progression in the United States

Authors


  • Funding agencies: This study was sponsored by Teva Neuroscience. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; or decision to submit this manuscript for publication. In addition, no Teva product is mentioned in this article, and the sponsor allowed the authors complete freedom to construct the model based on the best available data in the literature.

  • Relevant conflicts of interest/financial disclosures: M.D.D., A.K., and H.G.B. are employees of Analysis Group, Inc., which received consulting fees from Teva Neuroscience for this research. S.J.J. was an employee of Analysis Group, Inc. at the time of this research. A.D.S. received consulting fees for the work from the Analysis Group under a contract with Teva.

  • Full financial disclosures and author roles may be found in the online version of this article.

Correspondence to: Dr. Andrew D. Siderowf, Department of Neurology; Pennsylvania Hospital, 330 South 9th Street, Philadelphia, PA 19107, USA; andrew.siderowf@uphs.upenn.edu

ABSTRACT

Multiple studies describe progression, dementia rates, direct and indirect costs, and health utility by Hoehn and Yahr (H&Y) stage, but research has not incorporated these data into a model to evaluate possible economic consequences of slowing progression. This study aimed to model the course of Parkinson's disease (PD) and describe the economic consequences of slower rates of progression. A Markov model was developed to show the net monetary benefits of slower rates of progression. Four scenarios assuming hypothetical slower rates of progression were compared to a base case scenario. A systematic literature review identified published longitudinal H&Y progression rates. Direct and indirect excess costs (i.e., healthcare costs beyond what similar patients without PD would incur), mortality rates, dementia rates, and health utility were derived from the literature. Ten publications (N = 3,318) were used to model longitudinal H&Y progression. Base case results indicate average excess direct costs of $303,754, life-years of 12.8 years and quality-adjusted life-years of 6.96. A scenario where PD progressed 20% slower than the base case resulted in net monetary benefits of $60,657 ($75,891 including lost income) per patient. The net monetary benefit comes from a $37,927 decrease in direct medical costs, 0.45 increase in quality-adjusted life-years, and $15,235 decrease in lost income. The scenario where PD progression was arrested resulted in net monetary benefits of $442,429 per patient. Reducing progression rates could produce significant economic benefit. This benefit is strongly dependent on the degree to which progression is slowed. © 2013 Movement Disorder Society

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