Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: To estimate Parkinson’s Disease (PD)-related health care costs in a national sample of elderly patients in the US and examine the incremental cost burden of advanced PD (APD) vs. mild-moderate PD.
Background: As PD advances, patients develop more debilitating symptoms and are at increased risk for complications. However, little is known about associated health care costs.
Methods: Utilizing 100% fee-for-service Medicare claims from 2013, we identified individuals aged ≥65 years with a PD diagnosis (ICD-9:332.0) and continuous coverage (Medicare Parts A, B, D). Those with pharmacy claims denoting a 30-day average levodopa equivalent dose of >1000 mg/day were classified as APD; others were classified as mild-moderate PD. Treatment claims were categorized based on diagnosis codes, as all-cause (any diagnosis), PD-related (primary diagnosis of PD), and probably PD-related (primary or secondary diagnosis of PD). Annual costs were calculated overall and by category (medical vs. pharmaceutical). Generalized linear models controlling for age, sex, race/ethnicity, region of residence, comorbidity/risk score, and any neurologist visit (yes/no) were used to estimate risk-adjusted total costs for APD and mild-moderate PD. Adjusted incremental costs of APD over mild-moderate PD were calculated.
Results: In the analytical sample (n=144,703), 28,974 individuals (20%) met our criterion for APD. For 2013, total all-cause costs were $21,947 for APD and $19,809 for mild-moderate PD. PD-related costs were $5,779 vs. $2,319 and probably PD-related costs were $12,229 vs. $7,836, respectively for APD and mild-moderate PD. For probably PD-related costs, the APD group had higher medical costs ($7,877 vs. $5,862) and pharmaceutical costs ($4,353 vs. $1,974), compared to the mild-moderate PD group. After risk-adjustment, the incremental costs of APD were $5110 (95%CI: $4,752-$5,467) for all-cause costs; $3,201 (95%CI: $3,060-$3,343) for PD-related costs; and $5,347 (95%CI: $5,075-$5,619) for probably PD-related costs (p<0.001, all models).
Conclusions: This study is the first to estimate the economic burden of APD in a national sample of US Medicare enrollees with prevalent APD identified using a medication based proxy. Understanding the excess costs associated with APD will help policy makers and practitioners allocate resources and set priorities to improve outcomes in this population.
To cite this abstract in AMA style:N. Dahodwala, P. Li, J. Jahnke, V. Ladage, P. Kandukuri, J. Zamudio, Y. Bao, Y. Jalundhwala, J. Doshi. Economic burden of advanced Parkinson’s disease in a national sample of elderly US Medicare beneficiaries: A prevalence-based estimate [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/economic-burden-of-advanced-parkinsons-disease-in-a-national-sample-of-elderly-us-medicare-beneficiaries-a-prevalence-based-estimate/. Accessed December 5, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/economic-burden-of-advanced-parkinsons-disease-in-a-national-sample-of-elderly-us-medicare-beneficiaries-a-prevalence-based-estimate/