Study Predicts Dramatic Rise in Parkinson’s Prevalence, Economic Burden

Parkinson’s disease may affect more than 1.6 million people in the United States by 2037, at an estimated annual economic burden of $79 billion, according to a recent study.

The study, “Current and projected future economic burden of Parkinson’s disease in the U.S.,” was published in the peer-reviewed journal npj Parkinson’s Disease.

Although Parkinson’s is one of the world’s fastest growing neurological diseases, not much is known about its associated economic burdens in the U.S. and other countries.

People with Parkinson’s disease “have higher medical care needs, lose the ability to work, often miss work, and require the assistance of paid and unpaid care partners. These indirect effects create ripple economic burdens,” researchers wrote.

A multidisciplinary team from different U.S. institutions now have acquired data concerning the prevalence and economic burden of Parkinson’s from public and private administrative claims data, the Medicare Current Beneficiary Survey, the Medical Expenditure Panel Survey, and a primary survey of 4,548 people, designed specifically for this study.

As of 2017, the group estimated that approximately one million people in the U.S. lived with Parkinson’s and that the total economic burden amounted to $51.9 billion. Of this, the group estimated that $25.4 billion consisted of direct medical costs, with the remaining $36.5 billion comprised of indirect and non-medical costs.

Indirect cost estimates included $14.2 billion in future earnings losses due to premature death, reduced employment, absenteeism (the number of days of work missed due to Parkinson’s ), presenteeism (days spent at work but unproductive for disease-related reasons), and social productivity losses in volunteer work.

Non-medical costs of approximately $7.5 billion included paid daily non-medical care, home modifications, motor vehicle modifications, and other expenses.

Finally, those living with Parkinson’s received an estimated $4.8 billion in disability income.

Medicare shouldered the greatest share of medical costs, as most Parkinson’s patients are older than 65. The group calculated that 90% of direct medical costs were borne by those eligible for Medicare, 7% relied on private insurance, and 3% relied on other coverage plans, such as Medicaid or the U.S. Department of Veterans Affairs, or were without coverage.

The researchers applied what they had discovered concerning Parkinson’s disease prevalence among the 2017 data to projections of U.S. population increase going though 2037.

According to the U.S. Census Bureau, the total population will increase by 14%, from approximately 326 million people to 372 million. At the same time, the over-65 population is expected to increase by about 62%, from roughly 50 million to 80 million.

Because Parkinson’s is more prevalent among this older population, its prevalence is expected to rise over the next two decades, from approximately 1.04 million in 2017 to about 1.64 million by 2037.

Applying the same calculus to their economic data, the group projected an increase to $79.1 billion by 2037, based on 2017 dollars.

Total direct medical costs are projected to increase by about 52%. Disability income, paid care, other non-medical costs, and care partner productivity loss could increase by roughly 50%. Finally, costs related to premature death, reduced employment, absenteeism, and presenteeism could increase by between 9% and 15%.

The authors wrote that their estimated current economic burden and their prediction regarding how it will increase, suggest that this burden was previously underestimated.

They argued that their primary survey provided them a key advantage over past studies that have relied exclusively upon secondary sources, such as Medicare records and the Medical Expenditure Panel Survey. Although patient-reported surveys are subject to certain biases, the group concluded that the relatively large sample size should mitigate that concern.

This argument receives some support from other groups, who seek to leverage economies of scale in estimating the burden of rare diseases in general, from patient-reported outcomes.

Despite this potential advantage, the authors described their estimates as cautious. Factors that increase longevity, such as declining tobacco abuse, could lead to increases in Parkinson’s prevalence.

Conversely, effective public health initiatives, preventive measures, and better access to specialist care could reduce future prevalence, which also would  reduce Parkinson’s future economic burden.

“Our results underscore the need for preventive or treatment measures that directly reduce the prevalence and/or impacts of PD [Parkinson’s disease], and for policy initiatives to better support affected individuals and families, improve disease management, provide work-site support, and enhance employment and occupational training,” the researchers concluded.