title: Direct medical costs associated with Parkinson's disease: a population-based study.
abstract: The objective was to provide population-based estimates of incremental medical costs associated with Parkinson's disease (PD) from onset forward. All Olmsted County, Minnesota, residents with confirmed PD onset from 1987 through 1995 (n = 92) and one age- and sex-matched non-PD referent subject per case were identified with retrospective record review and followed in provider-linked billing data for direct medical costs (excluding outpatient pharmaceutical costs) from 1 year before index (i.e., year of symptom onset) through 10 years after index. Costs for each referent subject were subtracted from those for his/her matched case. Tests for statistical significance used Wilcoxon signed ranks. Preindex costs were similar [median difference in annual costs (MD) = -3 dollars; P = 0.59]. One year post index, PD subjects exhibited borderline significantly higher costs compared to referent subjects (MD = 581 dollars; P = 0.052); the difference diminished over 5 years (MD = 118 dollars; P = 0.82). By 5 to 10 years, however, PD subjects exhibited significantly higher costs (MD = 1,146 dollars; P = 0.01). Over the full 10 years, excess costs were concentrated among PD subjects without rest tremor (MD = 2,261 dollars, P < 0.01, for those without tremor and -229 dollars, P = 0.99, for those with tremor). These population-based estimates of PD-associated direct medical costs from onset forward can uniquely inform policy decisions and cost-effectiveness research.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. leibson@mayo.edu
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Leibson
authors.forename: Kirsten Hall
authors.initials: KH
authors.lastname: Long
authors.forename: Demetrius M
authors.initials: DM
authors.lastname: Maraganore
authors.forename: James H
authors.initials: JH
authors.lastname: Bower
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Ransom
authors.forename: Peter C
authors.initials: PC
authors.lastname: O'Brien
authors.forename: Walter A
authors.initials: WA
authors.lastname: Rocca
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018672:Community Health Planning; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000191:economics* / Q000453:epidemiology; D012016:Reference Values; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors