Purpose

1
A National Estimate of Direct and Indirect Costs
of Parkinsons Disease Using Retrospective
Database Analysis

Katherine Anderson, Richard Faris, Lawrence
Brown, Dick Gourley, Greta Gourley, Carol Likens,
Shelley White-Means
The University of Tennessee Health Science
Center, College of Pharmacy, Memphis, TN

• HC073- Full Year Consolidated Data File
• Demographics
• 37,015 Participants
• Aggregate Utilization and Expenditures

• HC078 Medical Conditions File
• Reported Medical Conditions

Methods
Purpose
The purpose of this study was to estimate the
cost of illness of Parkinsons disease in the
United States. Figure 1-1 visually depicts the
Cost of Illness Model that was originally
described by Dorothy Rice in 1966.
In order to perform the data analysis, it was
necessary to merge all MEPS data files into one
file. The first step linked the Medical
Conditions File with the Consolidated Full Year
File and identified persons with Parkinsons
disease. In this step, if the person reported
having Parkinsons disease (ICD-9-CM code 332) in
the Medical Conditions File, then the persons
unique identifier (DUPERSID) was used to link
with the Consolidated Full Year File. This
resulted in the creation of a single file that
contained only persons with Parkinsons disease.
The second step of merging linked the resulting
first step file of persons with Parkinsons
disease to each of the Medical Event Files. This
resulted in the creation of a single file that
contained only persons with Parkinsons disease
and the medical events reported by that person
that were related to Parkinsons disease. Figure
1-2 visually depicts how a single year of data
was obtained.

• Persons with Parkinsons Disease
• Number of persons reporting Parkinsons disease
  (ICD9-CM 332)

• Medical Events Files
• Seven Separate Files
• Inpatient Hospital, Outpatient Hospital,
  Emergency Room, Prescription Medications,
  Office-Based Visits, Other Medical Expenses and
  Home Health Care

Cost of illness
Intangible Costs
Indirect Costs
Direct Costs

• Parkinsons Disease Patients and Seven Medical
  Event Files
• Parkinsons Disease Events

• Data Analysis File-2003
• Number of people reporting Parkinsons disease
• Direct and morbidity costs for Parkinsons
  disease related events available from Medical
  Event Files

Emotional Pain and Suffering
Morbidity Costs
Mortality Costs
Direct Medical Costs
Direct Non-Medical Costs
Figure 1-2
Results
Direct and indirect costs of Parkinsons disease
in the United States were estimated at
39,661,102,321 for the five year period of
1999-2003. Direct medical costs totaled
25,686,503,575 and direct non-medical
expenditures accounted for 328,048,817. The
majority of direct medical costs were found to be
associated with nursing home care for patients
with Parkinsons disease and prescription
medications for the treatment of Parkinsons
disease. Indirect costs resulting from lost
workdays, bed-days, and mortality totaled
10,870,870,402. The majority of indirect costs
was due to bed days (9,619,603,534), followed by
mortality costs (861,530,870) and lost workdays
(389,735,998).
Hospital Visits Emergency Room Prescriptions Rehab
ilitation Nursing Home Treatment by Medical
Professionals
Transportation Lodging Child Care Household
Expenses
Lost Earnings Due to Disability
Lost Earnings Due to Death
Conclusions
There were no statistically significant
differences in total cost of illness between
gender, education, age, marital status, income
level and region of residence found in this study
for patients with Parkinsons disease. This
study concluded that there are statistically
significant differences in direct medical costs
for male and female patients with Parkinsons
disease. This study also concluded that there
are statistically significant differences in
direct medical costs for patients who live in the
South compared to patients in the Northeast.
Direct non-medical costs were the least
frequently reported cost by patients with
Parkinsons disease in this study. Patients who
live in the South reported the largest proportion
of indirect costs due to morbidity. However,
there were no statistically significant
differences in selected demographic
characteristics and morbidity costs for patients
with Parkinsons disease. The overall total cost
of illness was estimated by this study to be over
six billion dollars annually for patients with
Parkinsons disease. While not as costly a
disease state as Alzheimers, Parkinsons disease
is a more costly disease when compared to
Multiple Sclerosis, a disease state with a
similar prevalence. This cost of illness
estimate has provided an initial understanding of
the costs associated with Parkinsons disease.
Background
Data on the economic burden of Parkinsons
disease is limited, but it is considered to be
one of the most expensive neurological disorders
to treat.1 Parkinsons disease is a common
chronic neurodegenerative disease for which there
is currently no cure.2,3 In the United States,
an estimated 500,000 to 1.5 million people have
Parkinsons disease, with approximately 50,000
new cases are diagnosed each year.4-6 Parkinsons
disease has a dramatic impact on a persons
quality of life and results in severe disability
despite the availability of a variety of
pharmacological and surgical treatments.3
References
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