Pharmacoeconomic considerations of treating patients with advanced Parkinson's disease

TY - JOUR

T1 - Pharmacoeconomic considerations of treating patients with advanced Parkinson's disease

AU - Reese, Jens P

AU - Dams, Judith

AU - Winter, Yaroslav

AU - Balzer-Geldsetzer, Monika

AU - Oertel, Wolfgang H

AU - Dodel, Richard

PY - 2012/5

Y1 - 2012/5

N2 - INTRODUCTION: Parkinson's disease (PD) is one of the most common neurodegenerative diseases. In the later (advanced) stages of PD, the initial treatment of early PD becomes less effective and long-term side effects of dopaminergic treatment become apparent. In advanced PD, motor and non-motor complications occur, which increase treatment costs. Increasing disability and impaired activities of daily living concomitantly raise indirect costs, due to loss in productivity. Hence, the economic burden of advanced PD is substantial for both the society and the patients with their caregivers.AREAS COVERED: A systematic literature search was performed involving the databases NHS CRD (National Health Service Centre for Reviews and Dissemination) and PubMed until July 15, 2011. "Parkinson" [Mesh] and "cost" were used as search terms in PubMed and only "Parkinson" in the CRD database.EXPERT OPINION: Economic evaluations are scarce and heterogeneous, and their interpretation may be limited due to methodological shortcomings. Dopamine agonists, COMT and MAO-B inhibitors as well levodopa infusion and deep brain stimulation are reported to be cost-effective in the respective decision frameworks. However, these results are heavily dependent on assumptions of drug costs and effect sizes used in the models. More detailed real-life information from long-term clinical trials is needed to feed the economic models, especially for head-to-head comparisons. To date, no economic evaluation has been undertaken for possible neuroprotective/disease modifying effects, and further research is needed for evaluations of interventions for non-motor symptoms.

AB - INTRODUCTION: Parkinson's disease (PD) is one of the most common neurodegenerative diseases. In the later (advanced) stages of PD, the initial treatment of early PD becomes less effective and long-term side effects of dopaminergic treatment become apparent. In advanced PD, motor and non-motor complications occur, which increase treatment costs. Increasing disability and impaired activities of daily living concomitantly raise indirect costs, due to loss in productivity. Hence, the economic burden of advanced PD is substantial for both the society and the patients with their caregivers.AREAS COVERED: A systematic literature search was performed involving the databases NHS CRD (National Health Service Centre for Reviews and Dissemination) and PubMed until July 15, 2011. "Parkinson" [Mesh] and "cost" were used as search terms in PubMed and only "Parkinson" in the CRD database.EXPERT OPINION: Economic evaluations are scarce and heterogeneous, and their interpretation may be limited due to methodological shortcomings. Dopamine agonists, COMT and MAO-B inhibitors as well levodopa infusion and deep brain stimulation are reported to be cost-effective in the respective decision frameworks. However, these results are heavily dependent on assumptions of drug costs and effect sizes used in the models. More detailed real-life information from long-term clinical trials is needed to feed the economic models, especially for head-to-head comparisons. To date, no economic evaluation has been undertaken for possible neuroprotective/disease modifying effects, and further research is needed for evaluations of interventions for non-motor symptoms.

KW - Antiparkinson Agents

KW - Economics, Pharmaceutical

KW - Humans

KW - Parkinson Disease

KW - Severity of Illness Index

KW - Journal Article

U2 - 10.1517/14656566.2012.677435

DO - 10.1517/14656566.2012.677435

M3 - SCORING: Journal article

C2 - 22475391

VL - 13

SP - 939

EP - 958

JO - EXPERT OPIN PHARMACO

JF - EXPERT OPIN PHARMACO

SN - 1465-6566

IS - 7

ER -