Study Details Economic Burden of Parkinson Disease in the United States

Based on findings of a study conducted by the Michael J. Fox Foundation for Parkinson Research, titled, “The Economic Burden of Parkinson’s Disease in the United States,” the individual annual economic burden for a patient with Parkinson disease (PD) amounted to $52,000, with nonacute institutional care, inpatient hospitalization, and outpatient care indicated as the largest drivers of cost among differing coverage plans.

As researchers note, the debilitating nature of PD often causes patients to experience injuries from falls and other comorbidities, which then contribute to rising medical costs. This could prove significant for both patients with PD (PwP) and respective caregivers as prior studies have highlighted the detrimental effect of OFF periods on work productivity and financial burden.

With over 1 million PwP in the United States (89% eligible for Medicare), and expectations that the PD prevalence rate will rise in the future, researchers sought to assess the economic burden of the disease by analyzing data on commercial claims for privately insured patients and Medicare claims. Data were gathered from the following sources:

• The Social and Financial Impact of Parkinson’s Disease Survey (the PD Impact Survey) was used to collect data for estimation of the indirect cost of PD (2018).
• The 2015 Medicare Current Beneficiary Survey and the 2011-2015 Medical Expenditure Panel Survey were used to collect Census population projections.
• A primary survey distributed via Fox Insight and Unified Parkinson's Advocacy Council communities was developed to capture the indirect costs of PD.

The researchers undertook a prevalence-based approach, in which the prevalence of PD was combined with per-capita costs by population characteristics. Direct costs, future earnings loss due to premature death by PD, and other indirect and nonmedical costs were all utilized in the analysis.

Based on results, the total economic burden of PD in the United States was $52 billion in 2017, with $25.4 billion attributed to direct medical costs. Per-capita annual excess medical costs were shown to be $24,439 for Medicare beneficiaries; $22,671 for those with private insurance; and $19,489 for those with other coverage plans or who were uninsured.

The indirect and nonmedical cost burden of PD attributed to PwP and caregivers was found to be even higher than direct costs, totaling to $26.5 billion. Approximately $20 billion fwas attributed to PwP and $6.6 billion to unpaid care partners. When stratified for specific cost, the total indirect cost was $14.2 billion, nonmedical cost was $7.5 billion, and PD-related disability benefit spending was $4.8 billion. Per-capita annual indirect and nonmedical cost was shown as $19,242 for PwP only and $25,558 for PWP combined with the caregiver burden.

The largest drivers of excess cost by coverage plan were indicated as nonacute institutional care for Medicare recipients, inpatient hospitalization for the privately insured, and outpatient care for those with other types of coverage.

The researchers note that the study’s findings on indirect and nonmedical costs represent figures generally higher than previous US-based PD burden studies.

“Our findings underscore the significant burden of PD to society, payers, patients, and caregivers… prevention strategies reducing PD incidence, symptom burden, and delaying disease progression will have significant implications in reducing [the] future burden of PD,” concluded the study authors.