Оценка Эффективности Доклинической Диагностики Болезни Паркинсона Методом "Затраты-Полезность"[Estimating economic efficiency of preclinical diagnostics of Parkinson disease with cost-utility approach]

Neurodegenerative diseases, Parkinson disease being an example, set challenges to modern societies both in terms of premature deaths and resources spent on treatment of the diseases. Prevention and early diagnostics in particular, are potential directions towards higher economic efficiency of healthcare interventions in this area. We suggest a way to modify the cost-utility approach to evaluation of economic efficiency of an early diagnostics method of Parkinson disease (PD) at the laboratory stage of the diagnostics method. The lack of detailed understanding of the early testing group selection and composition are the major challenges to economic evaluation here. In particular, we consider the approach to diagnose PD at the prodromal stage suggested by Ugrumov 2020. The early diagnostics at the prodromal stage, accompanied by neuroprotective therapy of those identified at high risk of PD, allows postponing PD development for later years. The innovative approach implies saving both direct and indirect costs of PD treatment in comparison with traditional approach but adds costs of testing for the high risk of PD. The latter component may be non-trivial depending on the rules of selection into the group of tested. We suggest a way to modify the cost-utility evaluation procedure so that to take this uncertainty into account. We formulate the economic efficiency condition of the early diagnostics method in terms of the minimal probability of PD in the tested group and estimate the probability based on the Russian data. The latter sets the important threshold for innovative technology when moving from the laboratory into the clinical stage.