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

Abstract

Multiple system atrophy and progressive supranuclear palsy are disabling neurodegenerative disorders, also known as atypical parkinsonian syndromes. Currently, no health economic evaluations of these diseases are available. The objective of this study was to evaluate disease-related costs in German patients with multiple system atrophy and progressive supranuclear palsy and to identify cost-driving factors. We recruited 101 consecutive patients with multiple system atrophy (n = 54) and progressive supranuclear palsy (n = 47) in four German specialised movement disorder clinics. The health economic data were collected using comprehensive health economic questionnaires ("bottom-up" approach). Costs were calculated from the societal perspective in 2010 Euros. Independent cost-driving factors were identified in multiple regression analysis. The total semi-annual costs of atypical parkinsonian syndromes were EUR 16,670 (95% CI: 13,470-21,850). Direct costs accounted for 73% (inpatient care 31%, special equipment 24%, copayments of patients 21%, others 24%) and indirect costs for 27% of total costs. The economic burden imposed on patients by atypical parkinsonian syndromes accounted for 36% of their income. Independent cost-driving factors were younger age, disease severity, living without a partner and depression. The disease-related costs of atypical parkinsonian syndromes in Germany are high and above the costs reported for idiopathic Parkinson's disease. Disease-specific patterns of cost distributions in atypical parkinsonian syndromes and independent cost-drivers should be considered in future health economic evaluations and healthcare programs. The early diagnosis and treatment of depression in patients with atypical parkinsonian syndromes as well as programs aimed to improve social support will reduce disease-related costs.

Progressive supranuclear palsy’s economical burden: the use and costs of healthcare resources in a large health provider in Israel

“…Data on the direct medical costs of PSP are scarce. Our findings are in line with two previous publications assessing the economic burden of PSP, demonstrating that disease severity is a significant contributor to the increase of direct costs [8,20]; the semiannual costs increased from €9290 in patients in early stages (1-2, measured by the Unified MSA Rating Scale, Part IV) to €20,630 in patients in advanced stages (4-5) [20]. Similar trends are shown in France, Germany and the UK where disease severity was measured using Parkinson Plus Symptoms scale [8].…”

Exploring the mechanism of astragalus membranaceus in the treatment of multiple system atrophy based on network pharmacology and molecular docking

“…[ 3 , 4 ] As the disease progresses, it can decrease the functions of the brain, cardiovascular system, respiratory system, urinary system, etc, [ 5 ] reducing the quality of life and increasing the burden on family and society. [ 6 , 7 ] The pathogenesis underlying MSA remains not fully understood. A loss-of-function mutation in the COQ2 gene encoding by coenzyme Q 10 synthase is the only certified cause of monogenic MSA till now.…”