Assessing The Economic Cost Of Pd
Cost-of-illness studies measure the economic burden of a disease. These studies may include direct costs and indirect costs . Direct costs can be used to help policy makers and other stakeholders make funding decisions, while indirect costs highlight the value of resources lost to society or the individual due to a particular illness. Estimates of the total burden of disease on society should
The Economic Burden Of Parkinsons Disease
Date Posted : July 5. 2019
The Michael J. Fox Foundation for Parkinsonâs Research recently commissioned a study on the annual economic burden of Parkinsonâs disease . The study was conducted by The Lewin Group and is the most comprehensive assessment of the economic burden of Parkinsonâs disease to date. The study also includes numerous ways Parkinsonâs affects a personâs financial well-being and ability to participate in the workforce.
The total cost of PD to individuals, families and the U.S. government is $51.9 billion annually. Of this, $25.4 billion is attributed to direct medical costs and $26.5 billion to non-medical costs like missed work, lost wages, early forced retirement and family caregiver time.
The study also revealed that the federal government alone spends nearly $25 billion annually in caring for people with PD. About $2 billion of that is shouldered by Social Security, and the remaining $23 billion is in Medicare costs.
Multiple data sources were used to fully analyze the cost components of PD. Having a data-driven understanding of PD costs supports MJFFâs research mission to fund work toward better treatments to alleviate the urgent need today and the growing burden tomorrow.
Learn more about the study on The Michael J. Fox Foundation website.
Significant Changes In Inflammatory Metabolic Pathways
Functional annotation was performed using HUMANn3 based on the metagenomic combined dataset , and then potential inflammatory metabolism-related pathways and genes were selected for further analysis. By reviewing the literature on Google Scholar with Parkinson and inflammation as keywords, four commonly reported metabolic pathways related to intestinal inflammation were identified,. SCFAs resist intestinal inflammation, while sulfate reduction, lipopolysaccharide, and glutamate promote intestinal inflammation. The genes of these four metabolic pathways were determined through the MetaCyc database. Finally, 7958 genes for these four metabolic pathways were extracted from the results of HUMANn3. The transcripts per million abundances of genes belonging to the same metabolic pathway were summed as the abundance of that metabolic pathway.
The TPM abundances of 63 genes were significantly changed in the combined dataset . Among them, 19 SCFAs genes were significantly decreased, and all sulfate reduction , lipopolysaccharide metabolism and glutamate metabolism genes were increased in PD. Moreover, the SCFAs pathway was significantly decreased, while the sulfate reduction, lipopolysaccharide and glutamate metabolism pathways were increased in PD .
Fig. 4: The contribution rate of genera to the four inflammation-related metabolic genes.
The value is the mean contribution rate in two Metagenomic datasets . Parkinsons disease . SCFAs short-chain fatty acids.
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Unmet Needs In Parkinsons Disease
Understanding of PD has advanced considerably over the past 10â15 years but many urgent unmet needs remain and these contribute towards the burden the condition imposes. A summary of key unmet needs in PD is given in Table 1. The most fundamental of these needs is a better understanding of PD pathophysiology, which would lead to holistic models of treatment with multiple modes of action rather than single-target strategies.4 A blind âtunnel visionâ strategy of purely addressing the dopaminergic system is unlikely to provide any neuroprotective or generally effective treatment. It is for this reason that levodopa, a molecule that is effective in multiple neurotransmitter pathways remains the most effective drug for PD and a myriad of drugs tried and tested for neuroprotection have failed at a huge cost to the industry.37 Whilst characteristic changes in the brain, such as death of dopaminergic neurones in basal ganglia and Lewy bodies, are well known, the factors that initiate PD and mediate progression are largely unknown. The gutâbrain hypothesis of PD aetiology is an interesting concept but considerable further evidence is needed before it can be accepted that the gut flora plays a key role in PD pathophysiology.30â33 Improved understanding could provide valuable insights for inhibiting or blocking these processes leading to improved treatments and outcomes.
How Can I Get Involved In Parkinsons Research
People with PD and their loved ones can help speed the cure and find medications to reverse its course. The Parkinsons Foundation pairs people in the PD community as primary research partners with scientists, industry and government to prioritize research areas, improve studies and influence stakeholders. Learn more about our Research Advocates program.
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Why Is This Study Important
Understanding the annual economic toll on people with PD, their families and the government helps when advocating for more federal funding for Parkinsons research. It also allows us to better serve people with PD and their families with programs to help them live better with the disease, touching on areas they are most concerned about and where we can have the most impact.
Parkinsons Disease Is An Illustrative Example Of A Disease Associated With Aging Where A Large Part Of The Costs Is Borne By The Municipalities
Unique Swedish DataThe study was based on the Swedish Parkinsons disease patient registry, PARKreg. PARKreg has been developed by the Swedish Movement Disorder Society in cooperation with Swedish Neuro Registries since 2012 and includes information on diagnosis, treatments, and outcomes in terms of clinical data and patients HRQoL. PARKreg presently includes information on 8200 patients with Parkinsons disease. The register provides a unique opportunity to analyze real-world data in Swedish clinical practice since observations in PARKreg reflect clinical practice .
Sweden has a system of unique personal identification numbers that makes it possible to link so-called quality registers, such as PARKreg, to other registries with individual-level administrative data. This creates a unique combination of patient-reported data of HRQoL, physician-reported data of clinical severity, and almost complete administrative data regarding resource use, costs, treatment patterns, and comorbidities.
In our study, we included patients in PARKreg with idiopathic Parkinsons disease in the Region of Skåne, a relatively large region in southern Sweden, comprising approximately 13% of the total Swedish population. The data were linked to the national prescribed drugs register, which contains close to 100% of all filled prescriptions, and the Skåne Healthcare Register, which contains all healthcare visits to primary care and specialized outpatient and inpatient care.
New Study Shows The Economic Burden Of Parkinsons Disease Double Previous Estimates
Total cost of Parkinsons disease to individuals, families and the U.S. government nearly $52 billion each year
NEW YORK A new study, The Economic Burden of Parkinsons Disease, published by the Michael J. Fox Foundation with support from the Parkinsons Foundation and other community organizations and industry partners, reveals that the economic burden of Parkinsons disease is nearly $52 billion every year.
The study divides the cost nearly evenly between those attributable to direct medical costs versus non-medical costs . The federal government alone accounts for nearly $25 billion in this spending, with $2 billion supported through Social Security and the remaining $23 billion in Medicare costs.
These results provide deep insight into the indirect costs those costs the people living with Parkinson’s and their families must take on alone, added Parkinsons Foundation Senior Vice President and Chief Scientific Officer James Beck, PhD. Knowing this information will allow us to better serve people with Parkinsons and their families in the areas they are most concerned about and where we can have the most impact.”
The study, The Economic Burden of Parkinsons Disease, was sponsored by The Michael J. Fox Foundation, with support from the Parkinsons Foundation, several industry groups , the American Parkinson Disease Association and The Parkinson Alliance.
The Economic Burden Of Parkinsons Disease In The United States
C. Tanner, R. Albin, N. Dahodwala, R. Dorsey, W. Yang, L. Schmiel, I. Cintina, C. Kopil, J. Beck, J. Hamilton
Session Time: 1:15pm-2:45pm
Location: Les Muses, Level 3
Objective: To provide a comprehensive assessment of the direct and indirect medical costs of PD in the US
Background: In addition to the debilitating symptoms of PD itself, people with PD also experience injuries from falls and other comorbidities. As a result, PWP have higher medical needs, often miss work, retire early and require caregiver assistance. PD prevalence is predicted to increase in coming decades. Comprehensive information on the economic burden of PD is needed.
Method: Multiple data sources were used to estimate the different components of the cost of PD, including: The US Census population projections combined with Medicare Current Beneficiary Survey and the Medical Expenditure Panel Survey data claims data from Medicare Standard Analytical File , non-acute care and prescription drug components from the MCBS, CDC Wonder data, average earnings data from Bureau of Labor Statistics, and one of the largest claims databases for the privately insured. Other indirect and non-medical cost components were estimated using a primary survey that was designed and implemented for this study. Costs were determined for an estimated 1 million Americans with PD using 2017 costs.
To cite this abstract in AMA style:
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The Societal Burden Of Parkinsons Disease Associated With Putative Aetiologies And Pathophysiology
Various studies and meta-analyses have shown statistically significant associations between PD risk and environmental factors such as chronic exposure to agricultural chemicals , solvents and metals .27â29 Thus, workers in farming, metallurgy and textiles are believed to have increased risk although more epidemiological studies are necessary to substantiate these risks and determine whether they actually contribute to increasing prevalence. An emerging proposed aetiology in PD is the gutâbrain hypothesis.30â32 This putative mechanism is gaining interest and suggests that microbial disturbances in the gut and consequent T cell-driven inflammation, lead to misfolding of Î±-synuclein, which is a key component of Lewy bodies. PD has been positively correlated with inflammatory bowel diseases which further supports this hypothesis.33 It is therefore possible that inflammation mediated by T cells, which produces dopaminergic neurodegeneration in PD, is initiated by a disturbed gut mucosa. This aetiology is intriguing but is not supported by post-mortem evidence34 and requires much further investigation. If substantiated, it could lead to development of novel approaches to PD treatment and prevention.
Improving Nice Evidence For Economic Impacts Of Parkinson’s Disease On Households And The Nhs
As would be expected of the National Institute for Health and Care Excellence guidelines on Parkinson’s disease issued in 2006 , and the updated guideline published earlier this year , the central tenet of the document uses the latest evidence from randomised controlled trials to inform clinical management decisions. Updated guidelines however do not revisit the health economics as the cost of illness or burden of disease studies are not considered useful in the decision-making for guideline development .
In regard to adverse effect of dopamine-replacement therapies, as compared to 14-24% reported by Rogers et al. 2017 our study found 34% of PwP reporting impulsive and compulsive behaviours, which can range from compulsive gambling to binge eating and hyper-sexuality, as a result of the medication. This behaviour has resulted in out-of-pocket expenditure for impulse control disorders behaviours has caused financial distress to PwPs and their families with some of them even reporting over £10,000 expenditure on these activities. To control for ICDs behaviours, 26% of PwP had purchased over the counter medications or supplements and on average spending additional £56 every month. Furthermore, one-thirds of PwP were spending more on takeaways and convenience food every month on a regular basis with additional monthly spent of £74 per household.
Competing interests: No competing interests
26 October 2017
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15 December 2022
A. W. Willis, E. Roberts, on behalf of the Parkinsons Foundation P4 Group
06 October 2022
Daniel Oudin Åström, Jacob Simonsen, Per Odin
volume 6, Article number: 15
Societal Burden And Persisting Unmet Needs Of Parkinsons Disease
European Neurological Review.
Parkinsonâs disease, patient burden, economic burden, societal burden, unmet needs
The burdens of Parkinsonâs disease are undeniably serious and increasing while various unmet needs remain, especially the absence of disease-modifying therapies and the difficulty of finding new treatments that are effective in patients.1â7 Although this seems a discouraging situation, considerable advances in understanding the pathophysiology of PD and the identification of new targets for treatments suggest that the situation is improving.3,8â10 In addition, better use of available protocols and technologies have the potential to provide earlier detection of PD and initiate palliative treatments sooner particularly for the non-motor symptoms which have as much, or greater, impact on people with PD than motor symptoms which, until now, have been the primary focus of physicians and the treatments they prescribe.11,12 This review considers the current and future burden of PD and the unmet needs in PD, and ongoing progress made in alleviating them.
Predicting Pd With Inflammatory Microbes And Genes
The above results have demonstrated that the relative abundances of potential inflammation-related microorganisms and genes in PD changed significantly. These differential microorganisms and genes were then used to build classification models through three machine learning methods , support vector machines , and random forests ), and the receiver operating characteristic curve and the area under the curve were used to evaluate the model performance. Based on the 32 genera which significantly changed in PD, the classification model with high accuracy can be obtained , and the performance of RF was better than that of SVM and LR . Based on the 63 genes which significantly changed in PD, the classification model with high accuracy also can be obtained , and the performance of RF was better than that of SVM and LR . Therefore, RF was chosen for further analysis.
Fig. 6: The prediction models constructed by machine learning.
The receiver operating characteristic curve of models was calculated based on 32 genera and 63 genes with three different methods , support vector machines , and random forests ). The performance of the optimal model using 11 genera or 6 genes on training and test sets.
Economic Burden Analysis Of Parkinsons Disease Patients In China
Background and Objective. Parkinsons Disease is a progressive neurodegenerative disorder, which is prevalent in people over 65 years old. PD reduces patients quality of life and exerts a heavy economic burden on patients and their families. The purpose of this research is to identify the costs of PD and to evaluate the economic distribution of medical care for PD patients in China. Methods. A professional survey was administered to 116 patients with PD. Records of medical cost were reviewed. Direct and indirect costs were analyzed. The main cost-driving factors of PD were identified using multivariate regression analysis. Results. The average annual cost per PD patient in China is $3,225.94, with direct and indirect costs accounting for $2,503.46 and $722.48, respectively. Direct costs consist of $556.27 for surgery, $44.67 for appointment fees, $605.67 for prescription medication, $460.29 for hospitalization, $71.03 for auxiliary examination, $35.64 for transportation, $10.39 for special equipment, and $719.50 for formal care. The total cost is closely related to surgical treatment, dopamine agonist, and levodopa costs.. The cost of PD patients in China is considerable and exceeds average economic capacity, especially antiparkinson medication and caring costs. This study may provide a reference for PD healthcare optimization in the future.
2. Design and Methods
2.2. Survey Design
2.3. Direct Cost
2.4. Formal Care
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Direct Costs In The Uk
A total of 432 patients were included in the survey and the total direct cost of care was £5993 per patient per year. At 38%, NHS costs represented the highest proportion of the direct costs, followed by social services costs and private expenditure . However, the NHS costs accounted for a much higher proportion of costs in the younger age groups . In patients < 65 years of age, NHS costs were 65% of the total compared with 21% in patients > 65 years. Conversely, both social
Total Cost Of Pd In The Uk
Using the figures described above and current PD prevalence rates, it is possible to extrapolate the overall cost of PD in the UK. The most conservative scenario assumes that there are 58,600 PD patients in the UK and uses the lost productivity approach to estimate indirect costs. The total cost using this approach is £449 million annually. As illustrated in Fig. 3, the cost increases if a higher prevalence of 100,000 patients in the UK is used, or if a different model is used to estimate the
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The Annual Economic Impact Of Parkinsons Disease In The United States Is Estimated To Be Around $108 Billion And Growing
According to the American Journal of Managed Care, the annual economic impact of Parkinsons disease in the United States is around $10.8 billion, including both direct medical expenses and indirect costs such as lost income, disability payments and medical costs.
The financial burden of Parkinsons disease on individuals and their families is immense. Drugs commonly used to treat Parkinsons disease can cost up to $6,000 per year per patient. Surgical treatments for Parkinsons disease can cost $25,000 or more. As the disease progresses, institutional care at an assisted-living facility or nursing home may be required and these costs can exceed $100,000, per person annually.
The mental and emotional cost of PD on patients, families and friends cannot be quantified. What is clear is that investment in medical research that leads to better treatments for Parkinsons disease can save millions of dollars each year. Studies have indicated that for every dollar spent on high quality research $13 could be saved in direct and indirect costs. If new therapies could be found that could produce even a modest ten percent delay in the progression of Parkinsons disease, hundreds of millions of dollars could be saved every year.
Despite these prospects, Parkinsons disease continues to receive far less federal research support than most other disorders. Privately funded research must fill these huge gaps in federal funding.