US Economic, Social Cost of Advanced Parkinson’s in Billions, Study Says

Limitations in functional abilities due to advanced Parkinson’s disease result in billions of dollars of lost economic value in the U.S., but effective treatments that restore some essential abilities can lessen this lost value, a study reports.

Levodopa-carbidopa intestinal gel, sold in the U.S. under the brand name Duopa and as Duodopa in the EU and elsewhere, was the particular treatment noted in this study. The work was funded by AbbVie, which developed and markets this therapy.

The study, “The Social Value of Improvement in Activities of Daily Living among the Advanced Parkinson’s Disease Population,” was published in De Gruyter.

People with Parkinson’s, especially those with advanced disease, commonly have difficulty performing day-to-day activities. From a purely economic perspective, these difficulties result in costs to society as a whole — people with less functional ability are less able to be economically productive, and are more likely to require assistance with day-to-day necessities.

A team led by researchers at AbbVie, assisted by those at PRECISIONheor, a health economics company, analyzed a group of U.S. national databases to identify data for tens of thousands of Parkinson’s patients. The researchers then analyzed the data using a model called The Health Economics Medical Innovation Simulation (THEMIS).

“THEMIS brings together clinical trial results, observational datasets, and econometric [economic statistics] methods into a single framework that allows researchers to compute the value to society of various medical and social interventions,” the researchers wrote. “For this study, a refined THEMIS modeling framework was used that projects the lifetime trajectory of health, [functional ability], and medical spending for US residents over age 65 with [advanced or non-advanced Parkinson’s].”

From their model, the researchers estimated the total cost to society imposed by the limitations of advanced Parkinson’s disease to be $17.7 billion over the life-years of this patient population. The dollar’s value in 2015 dollar was the study’s benchmark.

“The results demonstrated that the disability component of [advanced Parkinson’s disease] alone impose a sizeable economic burden to society, equivalent to $17.7B,” the researchers wrote.

Researchers then tested the effect of treatment on this cost. Specifically, they assessed AbbVie’s levodopa/carbidopa intestinal gel (LCIG).

Based on data from clinical trials of LCIG, the researchers estimated that, compared to a patient receiving standard of care, a patient on LCIG treatment would be 76% less likely to experience difficulty walking. The same analysis indicated that LCIG-treated patients would be 43% less likely to have trouble dressing, and 38% less likely to have trouble bathing.

The economic model estimated that LCIG treatment improving walking ability would cut limitation-associated societal costs by $1.4 billion. A better ability to dress one’s self would cut societal costs by $900 million, while improvements in bathing abilities would cut costs by $200 million.

Combining improvements in all three abilities produced greater cost savings (to payers and patients) than each individually: by $2.6 billion, or about 15% of the total $17.7 billion cost to society.

Additional statistical analyses found largely consistent results. Of note, treatment-driven improvements in functional abilities were also associated with less time spent in nursing homes and lower Medicaid expenditures.

“Reduced limitations in [functional ability] that are of a magnitude consistent with LCIG treatment, improved health outcomes and reduced healthcare costs for [advanced Parkinson’s disease] patients in the US over their lifetimes,” the team concluded.

The researchers noted several limitations to this study; for example, some of the databases used did not specifically define whether or not individuals had Parkinson’s. The researchers also noted that the THEMIS model has “many sources of uncertainty” because it is making estimates, and acknowledged that there is some subjectivity in determining what constitutes “advanced” or “non-advanced” Parkinson’s.

Researchers called for further study to determine the cost-savings of effective Parkinson’s treatments.