Costs of illness in a Russian cohort of patients with Parkinson's disease.
BACKGROUND
The economic burden associated with Parkinson's disease (PD) is increasing as the worldwide population ages. While cost-of-illness studies for PD from developed countries have recently been published, data for Eastern Europe and Asia are still lacking.


OBJECTIVE
To prospectively evaluate direct and indirect costs in a cohort of Russian patients with PD in order to identify cost-driving factors.


METHODS
We recruited 100 patients with idiopathic PD who visited the outpatient department for movement disorders of the Russian Medical State University in Moscow between October 2004 and December 2005. The Unified Parkinson's Disease Rating Scale was used to evaluate clinical status. Economic data were collected in a 'bottom-up' approach and evaluated from the societal perspective. Indirect costs were estimated using a human capital approach. Russian currency was converted into euro, year 2005 values, using the purchasing power parity. All costs were then inflated to euro, year 2008 values, using the Medical Care Component of the Consumer Price Index. Independent cost predictors were identified by means of multivariate regression analyses.


RESULTS
From the societal perspective, total costs per patient over 6 months amounted to euro2620 (95% CI 2050, 3200), with direct costs accounting for 67% and indirect costs for 33% of the total. Patients' expenditures accounted for 43% of their private income. The primary burden on patients was due to informal care and drugs. Only 10% of home care was provided by the formal service sector. Costs for the nation are estimated at euro1.1 billion per year.


CONCLUSIONS
The economic burden of PD in Russia is considerable, especially when taking into account low private incomes. Further development of a formal care system and better reimbursement systems for drugs are necessary in Russia.
Winter
Yaroslav
Y
Department of Neurology, Philipps University Marburg, Marburg, Germany.
von Campenhausen
Sonja
S
Popov
Georgy
G
Reese
Jens P
JP
Klotsche
Jens
J
Bötzel
Kai
K
Gusev
Eugene
E
Oertel
Wolfgang H
WH
Dodel
Richard
R
Guekht
Alla
A
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D006699:Home Care Services / Q000191:economics; D006801:Humans; D007297:Inpatients; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics; D010300:Parkinson Disease / Q000191:economics*; D011446:Prospective Studies; D012426:Russia