An economic model of Parkinson's disease: implications for slowing progression in the United States.
Identifieur interne : 000B05 ( Main/Exploration ); précédent : 000B04; suivant : 000B06An economic model of Parkinson's disease: implications for slowing progression in the United States.
Auteurs : Scott J. Johnson [États-Unis] ; Melissa D. Diener ; Anna Kaltenboeck ; Howard G. Birnbaum ; Andrew D. SiderowfSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2013.
Descripteurs français
- Wicri :
- geographic : États-Unis.
English descriptors
- KwdEn :
- Cost-Benefit Analysis, Disease Progression, Female, Health Care Costs (statistics & numerical data), Humans, Male, Markov Chains, Models, Econometric, Parkinson Disease (economics), Parkinson Disease (epidemiology), Parkinson Disease (psychology), Probability, Quality of Life, Reproducibility of Results, Sensitivity and Specificity, Time Factors, United States (epidemiology).
- MESH :
- geographic , epidemiology : United States.
- economics : Parkinson Disease.
- epidemiology : Parkinson Disease.
- psychology : Parkinson Disease.
- statistics & numerical data : Health Care Costs.
- Cost-Benefit Analysis, Disease Progression, Female, Humans, Male, Markov Chains, Models, Econometric, Probability, Quality of Life, Reproducibility of Results, Sensitivity and Specificity, Time Factors.
Abstract
Multiple studies describe progression, dementia rates, direct and indirect costs, and health utility by Hoehn and Yahr (H&Y) stage, but research has not incorporated these data into a model to evaluate possible economic consequences of slowing progression. This study aimed to model the course of Parkinson's disease (PD) and describe the economic consequences of slower rates of progression. A Markov model was developed to show the net monetary benefits of slower rates of progression. Four scenarios assuming hypothetical slower rates of progression were compared to a base case scenario. A systematic literature review identified published longitudinal H&Y progression rates. Direct and indirect excess costs (i.e., healthcare costs beyond what similar patients without PD would incur), mortality rates, dementia rates, and health utility were derived from the literature. Ten publications (N = 3,318) were used to model longitudinal H&Y progression. Base case results indicate average excess direct costs of $303,754, life-years of 12.8 years and quality-adjusted life-years of 6.96. A scenario where PD progressed 20% slower than the base case resulted in net monetary benefits of $60,657 ($75,891 including lost income) per patient. The net monetary benefit comes from a $37,927 decrease in direct medical costs, 0.45 increase in quality-adjusted life-years, and $15,235 decrease in lost income. The scenario where PD progression was arrested resulted in net monetary benefits of $442,429 per patient. Reducing progression rates could produce significant economic benefit. This benefit is strongly dependent on the degree to which progression is slowed.
DOI: 10.1002/mds.25328
PubMed: 23404374
Affiliations:
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Diener</name></author><author><name sortKey="Kaltenboeck, Anna" sort="Kaltenboeck, Anna" uniqKey="Kaltenboeck A" first="Anna" last="Kaltenboeck">Anna Kaltenboeck</name></author><author><name sortKey="Birnbaum, Howard G" sort="Birnbaum, Howard G" uniqKey="Birnbaum H" first="Howard G" last="Birnbaum">Howard G. Birnbaum</name></author><author><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D" last="Siderowf">Andrew D. 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Johnson</name><affiliation wicri:level="2"><nlm:affiliation>Analysis Group, Inc, Boston, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Analysis Group, Inc, Boston, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Diener, Melissa D" sort="Diener, Melissa D" uniqKey="Diener M" first="Melissa D" last="Diener">Melissa D. Diener</name></author><author><name sortKey="Kaltenboeck, Anna" sort="Kaltenboeck, Anna" uniqKey="Kaltenboeck A" first="Anna" last="Kaltenboeck">Anna Kaltenboeck</name></author><author><name sortKey="Birnbaum, Howard G" sort="Birnbaum, Howard G" uniqKey="Birnbaum H" first="Howard G" last="Birnbaum">Howard G. Birnbaum</name></author><author><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D" last="Siderowf">Andrew D. Siderowf</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Disease Progression</term><term>Female</term><term>Health Care Costs (statistics & numerical data)</term><term>Humans</term><term>Male</term><term>Markov Chains</term><term>Models, Econometric</term><term>Parkinson Disease (economics)</term><term>Parkinson Disease (epidemiology)</term><term>Parkinson Disease (psychology)</term><term>Probability</term><term>Quality of Life</term><term>Reproducibility of Results</term><term>Sensitivity and Specificity</term><term>Time Factors</term><term>United States (epidemiology)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United States</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Health Care Costs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Male</term><term>Markov Chains</term><term>Models, Econometric</term><term>Probability</term><term>Quality of Life</term><term>Reproducibility of Results</term><term>Sensitivity and Specificity</term><term>Time Factors</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Multiple studies describe progression, dementia rates, direct and indirect costs, and health utility by Hoehn and Yahr (H&Y) stage, but research has not incorporated these data into a model to evaluate possible economic consequences of slowing progression. This study aimed to model the course of Parkinson's disease (PD) and describe the economic consequences of slower rates of progression. A Markov model was developed to show the net monetary benefits of slower rates of progression. Four scenarios assuming hypothetical slower rates of progression were compared to a base case scenario. A systematic literature review identified published longitudinal H&Y progression rates. Direct and indirect excess costs (i.e., healthcare costs beyond what similar patients without PD would incur), mortality rates, dementia rates, and health utility were derived from the literature. Ten publications (N = 3,318) were used to model longitudinal H&Y progression. Base case results indicate average excess direct costs of $303,754, life-years of 12.8 years and quality-adjusted life-years of 6.96. A scenario where PD progressed 20% slower than the base case resulted in net monetary benefits of $60,657 ($75,891 including lost income) per patient. The net monetary benefit comes from a $37,927 decrease in direct medical costs, 0.45 increase in quality-adjusted life-years, and $15,235 decrease in lost income. The scenario where PD progression was arrested resulted in net monetary benefits of $442,429 per patient. Reducing progression rates could produce significant economic benefit. This benefit is strongly dependent on the degree to which progression is slowed.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><noCountry><name sortKey="Birnbaum, Howard G" sort="Birnbaum, Howard G" uniqKey="Birnbaum H" first="Howard G" last="Birnbaum">Howard G. Birnbaum</name><name sortKey="Diener, Melissa D" sort="Diener, Melissa D" uniqKey="Diener M" first="Melissa D" last="Diener">Melissa D. Diener</name><name sortKey="Kaltenboeck, Anna" sort="Kaltenboeck, Anna" uniqKey="Kaltenboeck A" first="Anna" last="Kaltenboeck">Anna Kaltenboeck</name><name sortKey="Siderowf, Andrew D" sort="Siderowf, Andrew D" uniqKey="Siderowf A" first="Andrew D" last="Siderowf">Andrew D. Siderowf</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Johnson, Scott J" sort="Johnson, Scott J" uniqKey="Johnson S" first="Scott J" last="Johnson">Scott J. Johnson</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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