Yaroslav Winter (Department of Neurology, Philipps University, Marburg, Germany Center for Mental Health, Klinikum Stuttgart, Eberhard-Karls-University, Tubingen, Germany) Sonja von Campenhausen (Department of Neurology, Philipps University, Marburg, Germany Department of Neurology, Ludwig-Maximilians-University, Munich, Germany) Georgy Popov (Department of Neurology, Russian Medical State University, Moscow, Russia) Jens P. Reese (Department of Neurology, Russian Medical State University, Moscow, Russia) Jens Klotsche (Department of Neurology, Philipps University, Marburg, Germany) Kai Btzel (Department of Psychology and Psychotherapy, Technical University, Dresden, Germany) Eugene Gusev (Department of Neurology, Ludwig-Maximilians-University, Munich, Germany) Wolfgang H. Oertel (Department of Neurology, Philipps University, Marburg, Germany) Richard Dodel (Department of Neurology, Philipps University, Marburg, Germany) Alla Guekht (Department of Neurology, Russian Medical State University, Moscow, Russia)
Abstract
Background: The economic burden associated with Parkinson's disease (PD) is increasing as the worldwide population ages. While cost-of-illness studies for PD from developed countries have recently been published, data for Eastern Europe and Asia are still lacking. Objective: To prospectively evaluate direct and indirect costs in a cohort of Russian patients with PD in order to identify cost-driving factors. Methods and Patients: We recruited 100 patients with idiopathic PD who visited the outpatient department for movement disorders of the Russian Medical State University in Moscow between October 2004 and December 2005. The Unified Parkinson's Disease Rating Scale was used to evaluate clinical status. Economic data were collected in a 'bottom-up' approach and evaluated from the societal perspective. Indirect costs were estimated using a human capital approach. Russian currency was converted into €, year 2005 values, using the purchasing power parity. All costs were then inflated to €, year 2008 values, using the Medical Care Component of the Consumer Price Index. Independent cost predictors were identified by means of multivariate regression analyses. Results: From the societal perspective, total costs per patient over 6 months amounted to €2620 (95% CI 2050, 3200), with direct costs accounting for 67% and indirect costs for 33% of the total. Patients' expenditures accounted for 43% of their private income. The primary burden on patients was due to informal care and drugs. Only 10% of home care was provided by the formal service sector. Costs for the nation are estimated at €1.1 billion per year. Conclusion: The economic burden of PD in Russia is considerable, especially when taking into account low private incomes. Further development of a formal care system and better reimbursement systems for drugs are necessary in Russia.
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Article provided by Wolters Kluwer Health | Adis in its journal PharmacoEconomics.
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