Document Detail


Cost analysis of the treatments for patients with advanced Parkinson's disease: SCOPE study.
MedLine Citation:
PMID:  23035627     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To perform a comparative long-term analysis of the associated healthcare costs for the therapeutic options in advanced Parkinson's Disease (PD): deep brain stimulation (DBS), continuous duodenal levodopa-carbidopa infusion (CDLCI), and continuous subcutaneous apomorphine infusion (CSAI).
METHODS: Resource use associated with the pre-treatment period, procedure, and follow-up was assessed for the three therapies from the perspective of the Spanish national healthcare system. Resources consumption was measured with a Healthcare Resources Questionnaire (at nine advanced PD centres). Unit costs (Euro-Spain 2010) were applied to measure resource use to obtain the average total cost for each therapy over 5 years.
RESULTS: Mean cumulative 5-year cost per patient was significantly lower with DBS (€88,014) vs CSAI (€141,393) and CDLCI (€233,986) (p < 0.0001). DBS was associated with the lowest cumulative costs from year 2, with a yearly average cost of €17,603 vs €46,797 for CDLCI (p = 0.001) and €28,279 for CSAI (p = 0.008). For every patient treated annually with CDLCI, two could be treated with DBS (or €29,194 could be saved) and for every patient treated with CSAI, €10,676 could be saved with DBS. The initial DBS investment (32.2% of the total 5-year costs) was offset by decreases in anti-Parkinsonian drugs and follow-up costs. CDLCI and CSAI required constant drug use (i.e., levodopa and carbidopa for CDLCI, apomorphine for CSAI), representing ∼95% of their total 5-year cost.
LIMITATIONS: All costs were based on a questionnaire, not on actual clinical data. The study is not a cost-effectiveness analysis as there is a lack of comparable outcomes data. An expert panel was used due to the complexity and variability in the treatment of advanced PD. The sample size was relatively small.
CONCLUSIONS: Overall, DBS requires less use of health resources than CDLCI or CSAI in advanced PD patients, mostly pharmacological. The initial DBS investment was offset at year 2 by reductions in the ongoing consumption of anti-Parkinsonian medication. For every patient treated annually with CDLCI or CSAI, substantial cost savings could be made with DBS.
Authors:
Francesc Valldeoriola; Jaume Puig-Junoy; Ruth Puig-Peiró;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-29
Journal Detail:
Title:  Journal of medical economics     Volume:  16     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-06-18     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  191-201     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Antiparkinson Agents / economics*
Carbidopa / economics
Costs and Cost Analysis / methods
Deep Brain Stimulation / economics*
Health Resources / economics*,  utilization
Humans
Levodopa / economics
Parkinson Disease / economics,  therapy*
Questionnaires
Severity of Illness Index
Spain
Chemical
Reg. No./Substance:
0/Antiparkinson Agents; 46627O600J/Levodopa; MNX7R8C5VO/Carbidopa
Investigator
Investigator/Affiliation:
Victor Puente / ; Berta Pascual / ; Roberto Figueiras / ; Ignacio Regidor Baillo / ; Marta del Alamo de Pedro / ; Francisco Grandas / ; José Andrés Suárez Muñoz / ; José Arbelo / ; Pablo Mir / ; Fátima Carrillo / ; Pedro Roldán / ; Antonio Salvador / ; Paloma González / ; Cristina Canal /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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