title: Estimating the lifetime economic burden of Parkinson's disease in Singapore.
abstract: OBJECTIVE
  We aimed to estimate the lifetime cost of Parkinson's disease (PD) from the societal perspective.
  
  
  METHODS
  A convenience sample of English or Chinese-speaking patients with PD was recruited from a PD and Movement Disorders Centre in Singapore to complete a financial burden questionnaire. Sociodemographic and clinical data were retrieved from hospital databases. Markov cohort model analysis was performed (cycle length, 1-year; duration, death or reached 100 years old). Patients were assumed to progress from one Markov state to the next state or death without skipping states or regressing. All model parameters were based on published local data.
  
  
  RESULTS
  In 195 patients with PD (median age: 68.9, male: 51.8%), the simulated lifetime cost of PD was Singapore Dollar (SGD) 60,487 (EUR purchasing power parity 56,253) per patient. Direct medical, non-medical and indirect cost accounted for 18.8%, 12.8% and 68.4% of total lifetime cost, respectively. The top three components of total lifetime cost were productivity losses (67.6%), pharmacotherapy (11.4%) and home care (8.7%). One-way sensitivity analysis and probabilistic sensitivity analyses revealed that estimates were sensitive to cost at H&Y stage 1, 2 and 2.5 and productivity losses.
  
  
  CONCLUSIONS
  The lifetime cost of PD is evaluated for the first time. This cost is substantial and comparable to the lifetime cost of intracerebral haemorrhage in at least one study. Our study identified several priority areas for research and policy formulation: reducing productivity losses, reducing cost of pharmacotherapy, avoiding hospitalization and reducing home care cost.
authors.affiliation: Department of Pharmacy, National University of Singapore, Republic of Singapore.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Zhao
authors.forename: L C S
authors.initials: LC
authors.lastname: Tan
authors.forename: W L
authors.initials: WL
authors.lastname: Au
authors.forename: D M K
authors.initials: DM
authors.lastname: Heng
authors.forename: I A L
authors.initials: IA
authors.lastname: Soh
authors.forename: S C
authors.initials: SC
authors.lastname: Li
authors.forename: N
authors.initials: N
authors.lastname: Luo
authors.forename: H L
authors.initials: HL
authors.lastname: Wee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D010300:Parkinson Disease / Q000191:economics*; D012846:Singapore