Direct cost of Parkinson’s disease in a health system with high judicialization: evidence from Colombia

ABSTRACT

Objective: To estimate all-claims-all-conditions expenditures paid for by health plans for patients suffering from Parkinson´s disease (PD).

Methods: Using administrative claims data from two health maintenance organizations for 2014 and 2015 in Colombia, we identified 2,917 patients with PD by applying an algorithm that uses International Statistical Classification of Diseases and Related Health Problems and Anatomical Therapeutic Chemical Classification System codes. Descriptive statistics were applied to compute unadjusted all-cause median costs. A generalized linear model was used to estimate adjusted and attributable direct costs of advanced PD.

Results: Approximately 30% of the all-cause direct costs were associated with technologies not included in universal health coverage benefit packages. In 2015, the annual median interquartile range per patient all-cause direct costs to insurers was USD1,576 (605–3,617). About 16% of patients had advanced PD. Regression analysis estimated that additional costs attributable to advanced PD was USD3,416 (p = 0.000). Multimorbidity was highly prevalent, and 96% of PD patients had at least one other chronic condition.

Conclusions: In the context of high judicialization, patients suffering from PD must increasingly use the judicial system to access treatment. To promote more equitable and efficient access benefit packages, developing countries must consider more thoroughly the needs of these patients.

KEYWORDS:

• Parkinson’s disease
• cost of illness
• cost analysis
• judicialization
• health economics

Article highlights

• Median annual all-cause direct cost to health systems was USD1,576

• 30% of total annual direct cost is requested via the legal system

• 96% of patients with PD had at least another chronic condition

• About 16% of patients had advanced PD

• Severity was associated with increasing average costs by USD3,416 (p = 0.000)

Acknowledgments

Sharon Cáceres for her excellent research assistance.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

SP, AP, JV, MM, JO, and YT conceived and designed the research project. SP and AP performed the statistical analysis and wrote the first draft. SP, AP, JV, MM, JO, and YT reviewed and critiqued the manuscript. All authors reviewed and agreed with the final manuscript.

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Additional information

Funding

This paper was not funded.