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Movement Disorders Parkinson’s Disease Health Economics and Cost of Illness in Parkinson’s Disease Céu Mateus 1 and Joana Coloma 2 1. Assistant Professor; 2. Researcher and Former MSc Student, National School of Public Health, Lisbon, Portugal Abstract Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide. With a progressive course and no cure yet available, it is demanding for patients and their caregivers, but also for health and social support systems and ultimately for society as a whole. Everyday significant economic resources are spent due to PD, either directly on its treatment or in lost productivity. In this article, one tried to frame PD from an health economics’ perspective and cost of illness studies conducted in 11 countries (Austria, Czech Republic, Finland, France, Germany, Italy, Portugal, Russia, Sweden, UK and US), published from 1998 to 2011, were reviewed. One main aspect subsists: costs associated with this disorder are high, disproportionately higher that its prevalence and PD poses a substantial economic burden on individuals and society. Keywords Parkinson’s disease, cost of illness, indirect costs burden of disease. Disclosure: The authors have no conflicts of interest to declare. Received: 12 February 2013 Accepted: 28 March 2013 Citation: European Neurological Review, 2013;8(1):6–9 Correspondence: Céu Mateus, National School of Public Health, CMDT.LA, Nova University of Lisbon, Av Padre Cruz, 1600-560 Lisbon, Portugal. E: ceum@ensp.unl.pt Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide, the first being Alzheimer’s disease. In industrialised countries, PD has an estimated overall prevalence of 0.3  % and an estimated 1 % prevalence in the population of individuals over 60 years of age. PD disease manifests itself through neuromotor symptoms such as tremor, bradykinesia, rigidity and postural instability, as well as cognitive and neuropsychiatric changes, with PD patients presenting an increased risk of developing dementia or depression, amongst other disturbances of the thought, mood, speech and behaviour. 1 There are several pharmaceuticals available for the management of PD, but none that reaches the cure. With no cure yet possible, PD progresses chronically, affecting an increasing number of patients, imposing a heavy burden on these patients, their families, caregivers and on health and social support systems. 2,3 Economic Evaluation in Healthcare One of the many areas in which economic evaluations are performed is in the field of health comprehending healthcare provision, products and systems. In economics, as a premise, resources are limited and the needs upon their use are potentially unlimited. Thus, economic evaluations attempt to combine those conflicting realities by proposing guidelines for allocation of existing resources in the most rational way in order to meet the greatest number of needs while maximising the health of the population. Any contemporary healthcare system has to respond to the growing needs of the population covered, while having limited resources available to address those needs. To this problem adds the financial stress imposed by continuous healthcare innovation: with new drugs and new health technologies being created regularly, and increasingly faster. Therefore, it is of utmost importance and interest to payers of healthcare and to healthcare policy makers to have trustworthy information about 6 new healthcare products (either pharmaceuticals or new diagnostic or treatment techniques) enabling them to decide more rationally about whether or not to include those products in the services they provide to the users of the healthcare system. 4,5 Economic evaluation is a technique by which one identifies, measures, values and compares different alternatives in terms of their costs and consequences. 6 Economic evaluation can be applied specifically to pharmaceuticals in a study area also known as pharmacoeconomics, as well as to other products and services in the healthcare sector, either meant to diagnose, treat or manage a medical condition. Health economic evaluations aim to assess the economic advantage, i.e. as value for money, of a new drug or a new intervention by generating evidence showing that the health benefits are significant in relation to the benefits generated by the previously existing therapeutic alternatives and that implementing the new product would have costs that are bearable by the society when compared to the benefits arising from its use. 6 In the cases where, from the comparisons, the new technologies produce savings there are no doubts regarding the need for its adoption because resources are going to be freed for other uses in society. Economic Evaluation of Parkinson’s Disease Treatments To assess whether a given product provides economic advantage when compared to the existing alternatives, researchers conduct economic analysis. Thus the three main techniques used are cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Other types of analysis can be performed in health economics, but these three techniques are the ones considered as complete, for they achieve the full purpose of an economic evaluation, which is to compare at least two alternatives both in terms of their costs and consequences. 6 © Touch M Edical ME dia 2013