Transcript Purpose Methods Results Conclusions A National Estimate of Direct

A National Estimate of Direct and Indirect Costs of
Parkinson’s Disease Using Retrospective Database Analysis
Katherine Anderson, Richard Faris, Lawrence Brown, Dick Gourley, Greta Gourley, Carol Likens, Shelley White-Means
The University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN
Methods
Purpose
The purpose of this study was to estimate the cost of
illness of Parkinson’s disease in the United States. Figure
1-1 visually depicts the Cost of Illness Model that was
originally described by Dorothy Rice in 1966.
Cost of illness
Direct Costs
Direct
Direct
Medical NonCosts Medical
Costs
Hospital Visits
Emergency Room
Prescriptions
Rehabilitation
Nursing Home
Treatment by
Medical
Professionals
Indirect Costs
Morbidity
Costs
Intangible Costs
Mortality
Costs
Emotional
Pain and
Suffering
In order to perform the data analysis, it was necessary to
merge all MEPS data files into one file. The first step
linked the Medical Conditions File with the Consolidated
Full Year File and identified persons with Parkinson’s
disease. In this step, if the person reported having
Parkinson’s disease (ICD-9-CM code 332) in the Medical
Conditions File, then the person’s unique identifier
(DUPERSID) was used to link with the Consolidated Full
Year File. This resulted in the creation of a single file that
contained only persons with Parkinson’s disease. The
second step of merging linked the resulting first step file
of persons with Parkinson’s disease to each of the Medical
Event Files. This resulted in the creation of a single file
that contained only persons with Parkinson’s disease and
the medical events reported by that person that were
related to Parkinson’s disease. Figure 1-2 visually depicts
how a single year of data was obtained.
HC073- Full Year Consolidated Data File
Demographics
37,015 Participants
Aggregate Utilization and Expenditures
HC078 Medical Conditions File
Reported Medical Conditions
Persons with Parkinson’s Disease
Number of persons reporting Parkinson’s
disease (ICD9-CM 332)
Medical Events Files
Seven Separate Files:
Inpatient Hospital, Outpatient Hospital,
Emergency Room, Prescription Medications,
Office-Based Visits, Other Medical Expenses and
Home Health Care
Parkinson’s Disease Patients and Seven Medical Event Files
Parkinson’s Disease Events
Data Analysis File-2003
Number of people reporting Parkinson’s disease
Direct and morbidity costs for Parkinson’s disease related events available from Medical Event Files
Figure 1-2
Results
Transportation
Lodging
Child Care
Household
Expenses
Lost
Earnings
Due to
Disability
Direct and indirect costs of Parkinson’s disease in the United States were estimated at $39,661,102,321 for the five year period of 1999-2003. Direct medical costs
totaled $25,686,503,575 and direct non-medical expenditures accounted for $328,048,817. The majority of direct medical costs were found to be associated with
nursing home care for patients with Parkinson’s disease and prescription medications for the treatment of Parkinson’s disease. Indirect costs resulting from lost
workdays, bed-days, and mortality totaled $10,870,870,402. The majority of indirect costs was due to bed days ($9,619,603,534), followed by mortality costs
Lost Earnings ($861,530,870) and lost workdays ($389,735,998).
Due to Death
Background
Data on the economic burden of Parkinson’s disease is
limited, but it is considered to be one of the most expensive
neurological disorders to treat.1 Parkinson’s disease is a
common chronic neurodegenerative disease for which there
is currently no cure.2,3 In the United States, an estimated
500,000 to 1.5 million people have Parkinson’s disease, with
approximately 50,000 new cases are diagnosed each year.4-6
Parkinson’s disease has a dramatic impact on a person’s
quality of life and results in severe disability despite the
availability of a variety of pharmacological and surgical
3
treatments.
Conclusions
There were no statistically significant differences in total cost of illness between gender, education, age, marital status, income level and region of residence found in
this study for patients with Parkinson’s disease. This study concluded that there are statistically significant differences in direct medical costs for male and female
patients with Parkinson’s disease. This study also concluded that there are statistically significant differences in direct medical costs for patients who live in the South
compared to patients in the Northeast. Direct non-medical costs were the least frequently reported cost by patient’s with Parkinson’s disease in this study. Patients
who live in the South reported the largest proportion of indirect costs due to morbidity. However, there were no statistically significant differences in selected
demographic characteristics and morbidity costs for patients with Parkinson’s disease.
The overall total cost of illness was estimated by this study to be over six billion dollars annually for patients with Parkinson’s disease. While not as costly a disease
state as Alzheimer’s, Parkinson’s disease is a more costly disease when compared to Multiple Sclerosis, a disease state with a similar prevalence. This cost of illness
estimate has provided an initial understanding of the costs associated with Parkinson’s disease.
References
1
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5
6
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Dodel R, Berger K, Oertel W. Health-related quality of life and healthcare utilisation in patients with Parkinson's disease: Impact of motor fluctuations and dyskinesias. Pharmacoeconomics 2001; 19(10):1013-1038.
Lieberman A, McCall M. 100 questions and answers about Parkinson's disease. Boston, MA: Jones and Bartlett Publishers, Inc, 2003.
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Family Caregivers Alliance. Parkinson's disease. 2004. http://www.caregiver .org/caregiver/jsp/content_node.jsp?nodeid=577. Accessed 11-5 - 2005