| Cost Analysis of the Treatments for Patients with Advanced Parkinson's Disease: SCOPE Study. | |
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MedLine Citation:
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PMID: 23035627 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Francesc Valldeoriola; Jaume Puig-Junoy; Ruth Puig-Peiró; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-5 |
Journal Detail:
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Title: Journal of medical economics Volume: - ISSN: 1941-837X ISO Abbreviation: J Med Econ Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9892255 Medline TA: J Med Econ Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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