Estimating the lifetime economic burden of Parkinson's disease in Singapore

Authors

  • Y. J. Zhao,

    1. Department of Pharmacy, National University of Singapore, Republic of Singapore
    Search for more papers by this author
  • L. C. S. Tan,

    1. Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA National Parkinson Foundation International Centre of Excellence
    Search for more papers by this author
  • W. L. Au,

    1. Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA National Parkinson Foundation International Centre of Excellence
    Search for more papers by this author
  • D. M. K. Heng,

    1. Epidemiology & Disease Control Division, Ministry of Health, Republic of Singapore
    Search for more papers by this author
  • I. A. L. Soh,

    1. Epidemiology & Disease Control Division, Ministry of Health, Republic of Singapore
    Search for more papers by this author
  • S. C. Li,

    1. Department of Pharmacy, National University of Singapore, Republic of Singapore
    2. Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW, Australia
    Search for more papers by this author
  • N. Luo,

    1. Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
    Search for more papers by this author
  • H. L. Wee

    Corresponding author
    1. Department of Rheumatology & Immunology, Singapore General Hospital, Republic of Singapore
    • Department of Pharmacy, National University of Singapore, Republic of Singapore
    Search for more papers by this author

Correspondence: Dr H. L. Wee, Assistant Professor, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore (tel.: (65) 6516 5530; fax: (65) 6778 5698; e-mail: phawhl@nus.edu.sg).

Abstract

Background and purpose

We aimed to estimate the lifetime cost of Parkinson's disease (PD) from the societal perspective.

Methods

A convenience sample of English or Chinese-speaking patients with PD was recruited from a PD and Movement Disorders Centre in Singapore to complete a financial burden questionnaire. Sociodemographic and clinical data were retrieved from hospital databases. Markov cohort model analysis was performed (cycle length, 1-year; duration, death or reached 100 years old). Patients were assumed to progress from one Markov state to the next state or death without skipping states or regressing. All model parameters were based on published local data.

Results

In 195 patients with PD (median age: 68.9, male: 51.8%), the simulated lifetime cost of PD was Singapore Dollar (SGD) 60 487 (EUR purchasing power parity 56 253) per patient. Direct medical, non-medical and indirect cost accounted for 18.8%, 12.8% and 68.4% of total lifetime cost, respectively. The top three components of total lifetime cost were productivity losses (67.6%), pharmacotherapy (11.4%) and home care (8.7%). One-way sensitivity analysis and probabilistic sensitivity analyses revealed that estimates were sensitive to cost at H&Y stage 1, 2 and 2.5 and productivity losses.

Conclusions

The lifetime cost of PD is evaluated for the first time. This cost is substantial and comparable to the lifetime cost of intracerebral haemorrhage in at least one study. Our study identified several priority areas for research and policy formulation: reducing productivity losses, reducing cost of pharmacotherapy, avoiding hospitalization and reducing home care cost.

Ancillary