Economic burden of Parkinson's disease in a developing country: A retrospective cost analysis in Shanghai, China

Wang, Gang; Cheng, Qi; Zheng, Rui; Tan, Yuyan; Sun, Xiaokang; Zhou, Haiyan; Ye, Xiaolai; Wang, Ying; Wang, Zeng; Sun, Bomin; Chen, Shengdi

doi:10.1002/mds.20999

Cited by 57 publications

(42 citation statements)

References 19 publications

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“…Cubo et al [31] reported direct costs of EUR 10,524 per PD patient per year, which was similar to our findings. The annual direct costs of PD in our study were comparable to those reported from other Western European countries (EUR 7,920 in Sweden [5] , EUR 8,160 in Germany [10] , EUR 9,500 in the UK [32] ) but higher than those from countries in Eastern Europe (EUR 6,700 in the Czech Republic [11] , EUR 3,520 in Russia [12] ) or Asia (EUR 630 in India [33] , EUR 820 in China [34] ).…”

Section: Discussionsupporting

confidence: 80%

“…In our Italian cohort of patients with PD, dyskinesias were independent determinants of total costs. Interestingly, depression was identified as a cost-driving factor in our study though the majority of previous studies did not include depression in their multivariate analysis [8,10,32,34] . Future largescale studies should clarify if depression is a country-specific, cost-driving, independent factor in the Italian PD patient population.…”

Section: Discussionmentioning

confidence: 72%

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

et al. 2010

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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.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 72%

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

et al. 2010

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“…In addition, levodopa equivalent dose and number of drugs taken were closely associated with drug therapy cost. These results indicate that the economic burden of Chinese patients with PD is heavy [19]. …”

Section: Discussionmentioning

confidence: 99%

Remotely Programmed Deep Brain Stimulation of the Bilateral Subthalamic Nucleus for the Treatment of Primary Parkinson Disease: A Randomized Controlled Trial Investigating the Safety and Efficacy of a Novel Deep Brain Stimulation System

Li¹,

Zhang²,

Gault³

et al. 2017

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) is the most commonly performed surgery for the debilitating symptoms of Parkinson disease (PD). However, DBS systems remain largely unaffordable to patients in developing countries, warranting the development of a safe, economically viable, and functionally comparable alternative. Objective: To investigate the efficacy and safety of wirelessly programmed DBS of bilateral subthalamic nucleus (STN) in patients with primary PD. Methods: Sixty-four patients with primary PD were randomly divided into test and control groups (1:1), where DBS was initiated at either 1 month or 3 months, respectively, after surgery. Safety and efficacy of the treatment were compared between on- and off-medication states 3 months after surgery. Outcome measures included analysis of Unified Parkinson's Disease Rating Scale (UPDRS) scores, duration of “on” periods, and daily equivalent doses of levodopa. All patients were followed up both 6 and 12 months after surgery. Results: Three months after surgery, significant decrease in the UPDRS motor scores were observed for the test group in the off-medication state (25.08 ± 1.00) versus the control group (4.20 ± 1.99). Conclusions: Bilateral wireless programming STN-DBS is safe and effective for patients with primary PD in whom medical management has failed to restore motor function.

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“…Recent studies have identified a reduced quality of life and, thus, a potential socioeconomic impact of the diseases. To date, studies on the economic impact of PD and AP have involved the use of questionnaires with selected patients, the economic burden being estimated from this information [27][28][29][30][31][32]. The identification or assumptions of costs in these studies have primarily addressed direct costs, whereas indirect costs have not been identified.…”

Section: Introductionmentioning

confidence: 99%

The health-related, social, and economic consequences of parkinsonism: a controlled national study

et al. 2011

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Parkinson's disease (PD) and atypical parkinsonism (AP) cause a significant socioeconomic burden, but there is insufficient information about the total disease burden at a national level. Thus, the goal of this study was to estimate the excess direct and indirect costs of PD and AP in a national sample. Using records from the Danish National Patient Registry (1997-2007), 13,400 PD and 647 AP patients were identified and compared with, respectively, 53,600 and 2,588 control cases randomly selected with respect to age, gender, civil status, and geographic location. Direct costs including frequencies of primary and sector contacts and procedures, and medication from primary and secondary sectors were obtained from the Danish Ministry of Health, the Danish Medicines Agency, and the National Health Security. Indirect costs, which included labor supply and social transfer payments, were based on income data derived from the Coherent Social Statistics. Patients with PD and AP had significantly higher rates of health-related contact and medication use and a higher socioeconomic cost. Furthermore, they had very low employment rates, and those in employment had a lower income level than employed control subjects. The annual mean excess health-related cost was 6,500 ($8,975/£5,543) and 9,771 ($13,491/£8,332) for each patient with PD and AP, respectively. In addition, the patients with PD and AP received an annual mean excess social transfer income of 324 (£276/$447) and 844 (£719/$1,165), respectively. The employment- and health-related consequences could be identified up to 8 years before the first diagnosis and increased with disease advancement. PD and AP have major socioeconomic consequences for patients and society. The health effects are present for up to more than 8 years before a diagnosis of PD/AP.

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Economic burden of Parkinson's disease in a developing country: A retrospective cost analysis in Shanghai, China

Cited by 57 publications

References 19 publications

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

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

Remotely Programmed Deep Brain Stimulation of the Bilateral Subthalamic Nucleus for the Treatment of Primary Parkinson Disease: A Randomized Controlled Trial Investigating the Safety and Efficacy of a Novel Deep Brain Stimulation System

The health-related, social, and economic consequences of parkinsonism: a controlled national study

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