Like other chronic neurodegenerative diseases, Parkinson’s disease (PD) is associated with an impaired quality of life (QoL) for patients and costs to society. In Sweden at 2011 prices, the overall average cost per patient and year has been estimated at SEK (Swedish crowns) 148,000 or €16,500.1 In 2005 in Europe, the direct cost was estimated as €10.7 billion per year, but it was considered that the total costs may be around 40 % more.2 Significantly, future costs in developed countries were predicted to double by 2030.
Most of the costs associated with PD fall outside of the healthcare system, e.g. they are due to home care or lost productivity. A growing body of expertise believes that allocating more resources to early, optimised therapy can offset direct medication costs by raising patient QoL. This should reduce their need for home care and prolong the time they spend at work. We provide support for this view and show how economic simulation modelling can help generate meaningful cost-utility data.
Socioeconomic Experiences of Focused Treatment in Haemophilia
In developing countries with a per capita gross national product (GNP) of less than US$2,000, few citizens with haemophilia live beyond the age of nineteen. Many do not survive childhood. However, survival to adulthood and beyond increases approximately fivefold if these people have access to a specific haemophilia treatment centre (HTC).
Data collected by the World Federation of Haemophilia (WFH)3 clearly show that even minimal level treatment at a HTC boosted recovery from bleeding episodes and increased survival to adulthood. This resulted in a quicker return to school or work, as well as preserved functional independence. Absenteeism decreased, productivity improved and the burden on caregivers was reduced.
A relatively modest investment in the health of haemophilia sufferers thus benefits both government and society since as adults they are able to work and contribute to the community. The long-term financial consequences of higher morbidity are avoided.
This simple yet dramatic example has parallels with the treatment of PD in western countries. Although the costs of treating PD may be higher than the expenses of running a basic HTC, the economic resources of industrialised nations are correspondingly greater. So just as it makes economic sense for countries with even limited resources to provide organised haemophilia care, developed countries should evaluate the cost benefits of the therapeutic options available forPD. Expenses associated with providing optimised treatment as early as possible could be more than offset by improved outcome.
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