The economic burden of advanced Parkinson’s disease: an analysis of a UK patient dataset

Figures & data

Figure 1.  The Disease Specific Programme study.

Table 1.  Costs associated with the care of PD patients.

Total costs	Direct medical costs	Inpatient costs
		Outpatient costs	Consultant visits
			Other health care professionals visits: GP, PD nurse
			Telephone consultations*
		Pharmaceutical costs*	All medications including PD medications
	Direct non-medical costs	Nursing home/residential care/sheltered housing
		Home help and personal assistance
		Respite care
		Transportation to visits*
	Indirect costs	Informal care
		Sick leave due to PD*
		Retirement due to PD*

*Costs not included in the present analysis.

Table 2.  Mean annual resource use per health state.

Health State			Direct medical costs									Direct non-medical costs							Indirect costs
			Hospitalisation			Professional visits			Tests			Respite care			Living circumstances			Prof. carer (if living at home)	Informal carer
OFF	H&Y	Pts (n)	Mean patients admitted	Mean admissions per patient	Mean length of stay (days)	Mean Specialist visits	Mean GP visits	Mean PD nurse visits	MRI	CAT	SPECT	Mean patients admitted	Mean admissions per patient	Mean length of stay (days)	% nursing home	% residential care/sheltered housing	% at home	Mean hrs per week	Mean hrs per week
OFF I	3	130	0.23	0.32	15.2	2.85	2.90	2.34	0.24	0.30	0.04	0.08	0.25	11.55	2%	7%	91%	3.27	30.54
	4	76	0.49	0.66	12.5	2.94	3.37	3.34	0.26	0.37	0.05	0.16	0.42	9.75	14%	5%	80%	9.37	36.17
	5	15	0.60	0.87	16.4	1.60	5.87	2.75	0.07	0.47	0.00	0.27	0.93	10.50	60%	7%	33%	3.73	56.33
	Total	221	0.34	0.47	14.0	2.79	3.29	2.70	0.24	0.33	0.04	0.12	0.35	10.59	10%	6%	83%	5.40	34.00
OFF II	3	29	0.38	0.55	10.3	2.96	3.60	3.56	0.38	0.34	0.03	0.14	0.31	11.50	10%	3%	86%	8.67	36.43
	4	24	0.46	0.83	31.3	2.71	4.19	3.91	0.46	0.58	0.17	0.17	0.33	8.25	29%	4%	67%	9.08	31.94
	5	9	0.89	2.22	20.0	4.86	3.57	4.80	0.56	0.67	0.33	0.33	0.67	12.33	67%	11%	22%	1.56	16.83
	Total	62	0.48	0.90	20.6	3.11	3.79	3.83	0.44	0.48	0.13	0.18	0.37	10.55	26%	5%	69%	7.80	33.56
OFF III	3	2	0.50	0.50	5.0	2.00	3.50	3.00	0.50	0.50	0.00	0.00	0.00	–	50%	0%	50%	7.00	42.00
	4	6	0.83	1.67	9.6	3.33	4.17	4.00	0.67	0.50	0.00	0.17	0.50	8.00	33%	17%	50%	12.50	25.67
	5	3	0.67	4.33	9.5	5.50	–	9.50	0.67	0.67	0.00	0.00	0.00	–	67%	33%	0%	0.00	19.25
	Total	11	0.73	2.18	9.0	3.83	5.40	5.25	0.64	0.55	0.00	0.09	0.27	8.00	45%	18%	36%	8.09	26.25
OFF IV	3	0	–	–	–	–	–	–	–	–	–	–	–	–	–	–	–	–	–
	4	1	0.00	0.00	–	2.00	4.00	2.00	1.00	0.00	0.00	0.00	0.00	–	0%	0%	100%	0.00	56.00
	5	7	0.57	1.57	35.3	2.14	5.50	2.33	0.14	0.43	0.00	0.14	0.43	10.00	57%	0%	43%	24.00	49.67
Total		8	0.50	1.38	35.3	2.13	5.29	2.29	0.25	0.38	0.00	0.13	0.38	10.00	50%	0%	50%	21.00	51.25
Grand Total		302	0.39	0.65	16.1	2.86	3.52	3.00	0.29	0.37	0.06	0.13	0.35	10.50	16%	6%	78%	6.40	34.04

Table 3.  Unit costs for health state resource use.

Resource component	Calculated unit cost (£)	Source
Direct medical costs
Hospitalisation per HRG episode (reasons below)
Symptoms worsened/complex management	2,107.60 per episode
Weight loss/severe weight loss		19
Psychoses
Fall	1,750.45 per episode*	19
Urinary tract infection (UTI)	1,717.42 per episode*	19
Chest infection	2,059.44 per episode*	19
Rehabilitation	329.19 per day	19
Pressure sores	1,004.46 per episode*	19
Tests
MRI	220.76 per test*	19
CT	110.10 per test*	19
Single photon emission CT (SPECT)	214.44 per test	19
Consultations
GP	36.00 per visit	20
Hospital consultant	81.50 per visit	20
PD nurse specialist	25.83 per visit	20
Direct non-medical costs
Respite care (dependent on length of stay (LOS))
LOS ≤ 4 days	272.81 per day*	19
LOS = 5–8 days	264.92 per day*	19
LOS ≥ 9 days	255.41 per day*	19
Professional care
Local authority home care worker	20.32 per visit	20
Nursing home	678.80 per week†	20
Residential home	473.80 per week†	20
Indirect costs
Informal caregiver
Salary per hour	11.87 per hour	29

*Average of HRG cost options for this diagnosis.

†Includes district nurse visit costs.

Figure 2.  Mean number of carer hours per week. OFF states III and IV have a limited sample size (n = 11, 8, respectively).

Table 4.  Mean annual costs per health state.

Health state		n	Direct medical costs (£)			Direct non-medical costs (£)			Indirect costs* (£)			Total costs (£)
OFF	HY		Mean (CI)	Median	SD	Mean (CI)	Median	SD	Mean (CI)	Median	SD	Mean (CI)	Median	SD
I	3	130	1,040 (771; 1,309)	486	1,563	6,286 (4,377; 8,195)	0	11,105	10,730 (7,572; 13,888)	3,703	18,370	18,056 (14,317; 21,795)	11,692	21,753
	4	76	1,790 (1,357; 2,223)	727	1,928	16,797 (10,910; 22,684)	4,474	26,183	16,450 (11,415; 21,485)	8,641	22,394	35,037 (27,003; 43,071)	26,677	35,737
	5	15	1,975 (1,191; 2,759)	2,011	1,549	27,729 (21,829; 33,629)	35,298	11,659	13,908 (983; 26,833)	0	25,541	43,613 (33,198; 54,028)	38,753	20,580
II	3	29	1,643 (951; 2,335)	697	1,903	14,134 (8,216; 20,052)	11,094	16,261	17,059 (9,092; 25,026)	12,962	21,891	32,836 (23,706; 41,966)	32,772	25,084
	4	24	3,468 (1,740; 5,196)	901	4,319	21,339 (13,578; 29,100)	28,038	19,399	6,571 (1,541; 11,601)	0	12,572	31,377 (22,352; 40,402)	37,641	22,558
	5	9	5,400 (2,558; 8,242)	4,356	4,351	29,083 (21,665; 36,501)	35,298	11,354	3,463 (0; 7,416)	0	6,051	37,946 (33,185; 42,707)	38,574	7,287
III	3	2	1,465 (0; 3,151)	1,465	1,217	25,045 (4,950; 45,140)	25,045	14,499	12,962 (0; 38,367)	12,962	18,331	39,472 (35,848; 43,096)	39,472	2,615
	4	6	2,905 (1,103; 4,707)	2,742	2,252	29,553 (22,932; 36,174)	32,441	8,274	7,921 (216; 15,626)	4,321	9,629	40,379 (27,790; 52,968)	42,360	15,733
	5	3	6,282 (0; 13,470)	4,069	6,352	31,744 (24,780; 38,708)	35,298	6,155	7,921 (63; 15,779)	10,802	6,945	45,947 (41,689; 50,205)	47,431	3,763
IV	3	0	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
	4	1	579	579	NA	0	0	NA	34,565	34,565	NA	35,145	35,145	NA
	5	7	6,870 (0; 15,056)	2,204	11,051	45,996 (1,451; 90,541)	35,298	60,131	13,138 (0, 28,428)	0	20,641	66,005 (28,239; 103,771)	43,351	50,981
Total		302

*Limited to consideration of informal care costs.

When 95% CI values were negative a value of ‘0’ is presented.

Figure 3.  Distribution of mean annual costs according to time spent in OFF.