title: The economic burden of advanced Parkinson’s disease: an analysis of a UK patient dataset.
abstract: BACKGROUND
  To evaluate the cost burden of patients with advanced Parkinson's disease (PD) according to the waking hours per day spent in OFF state. An analysis of resource use comprising medical services, professional care and informal care data from an observational, cross-sectional study was conducted.
  
  
  METHODS
  A total of 60 physicians comprising 40 neurologists and 20 geriatricians across the UK participating in the Adelphi PD Disease Specific Programme took part. There were 302 PD patients at H&Y stages 3-5. Patients were characterised according to the percentage of time per day spent in OFF state (<25%, 26-50%, 51-75%, >75%).
  
  
  RESULTS
  Average 12-monthly total costs increased according to the time spent in OFF state from £25,630 in patients spending less than 25% of their waking hours in OFF to £62,147 for patients spending more than 75% of their time in OFF. Overall, 7% of costs were attributed to direct medical care, while 93% were split between direct non-medical professional care (50%) and indirect informal care (43%).
  
  
  CONCLUSIONS
  Low patient numbers in the more advanced disease stages of PD led to very little or no data to directly inform some of the severe health states of the analysis. Data gaps were filled in with data derived from a regression analysis which may affect the robustness of the analysis.
  
  
  CONCLUSIONS
  This study illustrates the increasing costs of advancing PD, in particular related to the time spent in OFF state, and identifies that the foremost cost burden is associated with the care needs of the patient rather than medical services.
authors.affiliation: IMS Health, 7 Harewood Avenue, London, NW1 6JB, UK.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Findley
authors.forename: Eifiona
authors.initials: E
authors.lastname: Wood
authors.forename: Julia
authors.initials: J
authors.lastname: Lowin
authors.forename: Claudia
authors.initials: C
authors.lastname: Roeder
authors.forename: Annika
authors.initials: A
authors.lastname: Bergman
authors.forename: Mathias
authors.initials: M
authors.lastname: Schifflers
mesh_terms: D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000191:economics* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D006113:United Kingdom