Document Detail

Cost Analysis of the Treatments for Patients with Advanced Parkinson's Disease: SCOPE Study.
MedLine Citation:
PMID:  23035627     Owner:  NLM     Status:  Publisher    
Abstract 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) versus 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 versus €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 antiparkinsonian drugs and follow-up costs. CDLCI and CSAI required constant drug use (i.e. levodopa and carbidopa for CDLCI, apomorphine for CSAI), representing around 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 antiparkinsonian medication. For every patient treated annually with CDLCI or CSAI, substantial cost savings could be made with DBS.
Francesc Valldeoriola; Jaume Puig-Junoy; Ruth Puig-Peiró;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-5
Journal Detail:
Title:  Journal of medical economics     Volume:  -     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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