Costs of Parkinson's disease and antiparkinsonian pharmacotherapy: an Italian cohort study.
OBJECTIVE
Antiparkinsonian pharmacotherapy is costly and the determinants of drug costs in Parkinson's disease (PD) have been poorly investigated. The objective of this study was to investigate the costs of PD and antiparkinsonian drugs in an Italian cohort of patients and identify cost-driving factors of drug therapy.


METHODS
Seventy outpatients with idiopathic PD were recruited in the Department of Neurology, Napoli University, Italy. Data on resource utilization were collected for 6 months using a bottom-up approach. Clinical status was evaluated using the Unified Parkinson's Disease Rating Scale. Direct and indirect costs were calculated from the societal perspective (figures of year 2009). Independent determinants of total costs and costs of antiparkinsonian drugs were identified using multivariate regression analysis.


RESULTS
The total costs of PD were EUR 8,640 (95% CI: EUR 6,700-11,240) per patient over a 6-month period. Direct costs accounted for 70% of the total costs. Antiparkinsonian drugs (EUR 1,450; 95% CI: EUR 1,220-1,760) were the primary component of costs paid by the health insurance (39.6%) and one of the most expensive components of the direct costs (24.0%). The highest copayments made by patients were for antiparkinsonian drugs and medical equipment (58%). Independent determinants of the increased costs of antiparkinsonian pharmacotherapy were younger age and occurrence of motor fluctuations.


CONCLUSIONS
Antiparkinsonian pharmacotherapy is one of the major cost components of PD-related costs for health insurance. It imposes a considerable economic burden on patients and their families as well.
Department of Neurology, Philipps University Marburg, Marburg, Germany.
Yaroslav
Y
Winter
Sonja
S
von Campenhausen
Jens P
JP
Reese
Monika
M
Balzer-Geldsetzer
Katia
K
Longo
Giuseppe
G
Spiga
Kai
K
Boetzel
Karla
K
Eggert
Wolfgang H
WH
Oertel
Richard
R
Dodel
Paolo
P
Barone
D000328:Adult; D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000191:economics* / Q000627:therapeutic use*; D015331:Cohort Studies; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000379:methods; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors
D000978:Antiparkinson Agents