Pharmacoeconomic Analysis of Using Sinemet CR over Standard Sinemet in Parkinsonian Patients with Motor Fluctuations

1998 ◽  
Vol 32 (9) ◽  
pp. 878-883 ◽  
Author(s):  
Alan G Hempel ◽  
Mary L Wagner ◽  
Mohamed A Maaty ◽  
Jacob I Sage
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Pharmacoeconomic Analysis ◽  
Tertiary Care ◽  
Motor Fluctuations ◽  
University Teaching ◽  
Total Cost ◽  
Medication Costs ◽  
The Cost

OBJECTIVE: To compare the costs of pharmacotherapy in patients with Parkinson's disease before and after converting from standard Sinemet to extended-release Sinemet CR. DESIGN: Investigators retrospectively reviewed records of patients converting from Sinemet to Sinemet CR for efficacy and total drug costs. Cost-effectiveness was evaluated retrospectively from data collected in prospective Sinemet CR efficacy trials. SETTING: Parkinson's disease clinic at a tertiary care university teaching hospital. PATIENTS: 100 patients with motor fluctuations who had undergone an initial 6-month course of Sinemet therapy, followed by a 6-month course of Sinemet CR. MAIN OUTCOME MEASURES: Total cost was measured as the cost of Sinemet formulations plus the costs of other antiparkinson medications. Differences in pre- and postconversion costs were compared by using the paired, two-tailed Student's t-test. A substudy of 39 patients on the cost-effectiveness of conversion measured the ratio of daily medication costs to the daily hours “on” without chorea. RESULTS: While total daily medication costs after conversion increased by 21%, patients experienced either a comparable or an improved degree of disease control with Sinemet CR. Patients who were also taking selegiline were able to decrease selegiline expense by 20%. The costs of other adjunctive medications did not differ significantly after conversion. The cost-effectiveness analysis revealed an increase in postconversion on time by 2.2 hours (p = 0.0001), accompanied by a $2.85 decrease in total cost per hour on without chorea (p = 0.11). CONCLUSIONS: Although Sinemet CR is more costly, it may be more cost-effective in patients with motor fluctuations. Some patients may be able to reduce adjunctive medications.

scholarly journals The cost-effectiveness of levodopa/carbidopa intestinal gel compared to standard care in advanced Parkinson’s disease

2017 ◽  
Vol 20 (11) ◽  
pp. 1207-1215 ◽  
Author(s):  
Julia Lowin ◽  
Kavita Sail ◽  
Rakhi Baj ◽  
Yash J. Jalundhwala ◽  
Thomas S. Marshall ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Standard Care ◽  
Advanced Parkinson’S Disease ◽  
The Cost

scholarly journals The Cost-Effectiveness of specialized Nursing Interventions for people with Parkinson’s Disease: the NICE-PD study protocol for a randomized controlled clinical trial

2019 ◽  
Author(s):  
Danique LM Radder ◽  
Herma H Lennaerts ◽  
Hester Vermeulen ◽  
Thies van Asseldonk ◽  
Cathérine CS Delnooz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Controlled Clinical Trial ◽  
Motor Symptoms ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
The Cost

Abstract Background Current guidelines recommend that every person with Parkinson’s disease (PD) should have access to Parkinson’s Disease Nurse Specialist (PDNS) care. However, there is little scientific evidence on the cost-effectiveness of PDNS care. This hampers wider implementation, creates unequal access to care and possibly leads to avoidable disability and costs. Therefore, we aim to study the (cost-)effectiveness of specialized nursing care provided by a PDNS compared to usual care (without PDNS) for people with PD in all disease stages. To gain more insight into the deployed interventions and their effects, a pre-planned subgroup analysis will be performed based on disease duration (diagnosis <5, 5-10, or >10 years ago). Methods We will perform an 18-month, single-blind, randomized controlled clinical trial in eight community hospitals in the Netherlands. A total of 240 people with PD that have not been treated by a PDNS over the past two years will be included, independent of disease severity or duration. In each hospital, 30 patients will randomly be allocated in a 1:1 ratio to either care by a PDNS (who works according to a recent guideline on PDNS care) or usual care. We will use two co-primary outcomes: quality of life (measured with the Parkinson’s Disease Questionnaire-39) and motor symptoms (measured with the MDS-UPDRS part III). Secondary outcomes include non-motor symptoms, health-related quality of life, experienced quality of care, self-management, medication adherence, caregiver burden and coping skills. Data will be collected after 12 months and 18 months by a blinded researcher. A healthcare utilization and productivity loss questionnaire will be completed every 3 months. Discussion The results of this trial will have an immediate impact on the current care of people with PD. We hypothesize that, by offering more patients access to PDNS care, quality of life will increase. We also expect healthcare costs to remain equal, as increases in direct medical costs (funding additional nurses) will be offset by a reduced number of consultations with the general practitioner and neurologist. If these outcomes are reached, wide implementation of PDNS care is warranted. Trial registration ClinicalTrials.gov: NCT03830190. Registered February 5, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03830190.

scholarly journals The Cost-Effectiveness of specialized Nursing Interventions for people with Parkinson’s Disease: the NICE-PD study protocol for a randomized controlled clinical trial

2019 ◽  
Author(s):  
Danique LM Radder ◽  
Herma H Lennaerts ◽  
Hester Vermeulen ◽  
Thies van Asseldonk ◽  
Cathérine CS Delnooz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Controlled Clinical Trial ◽  
Motor Symptoms ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
The Cost

Abstract Background Current guidelines recommend that every person with Parkinson’s disease (PD) should have access to Parkinson’s Disease Nurse Specialist (PDNS) care. However, there is little scientific evidence on the cost-effectiveness of PDNS care. This hampers wider implementation, creates unequal access to care and possibly leads to avoidable disability and costs. Therefore, we aim to study the (cost-)effectiveness of specialized nursing care provided by a PDNS compared to usual care (without PDNS) for people with PD in all disease stages. To gain more insight into the deployed interventions and their effects, a pre-planned subgroup analysis will be performed based on disease duration (diagnosis <5, 5-10, or >10 years ago). Methods We will perform an 18-month, single-blind, randomized controlled clinical trial in eight community hospitals in the Netherlands. A total of 240 people with PD that have not been treated by a PDNS over the past two years will be included, independent of disease severity or duration. In each hospital, 30 patients will randomly be allocated in a 1:1 ratio to either care by a PDNS (who works according to a recent guideline on PDNS care) or usual care. We will use two co-primary outcomes: quality of life (measured with the Parkinson’s Disease Questionnaire-39) and motor symptoms (measured with the MDS-UPDRS part III). Secondary outcomes include non-motor symptoms, health-related quality of life, experienced quality of care, self-management, medication adherence, caregiver burden and coping skills. Data will be collected after 12 months and 18 months by a blinded researcher. A healthcare utilization and productivity loss questionnaire will be completed every 3 months. Discussion The results of this trial will have an immediate impact on the current care of people with PD. We hypothesize that, by offering more patients access to PDNS care, quality of life will increase. We also expect healthcare costs to remain equal, as increases in direct medical costs (funding additional nurses) will be offset by a reduced number of consultations with the general practitioner and neurologist. If these outcomes are reached, wide implementation of PDNS care is warranted. Trial registration ClinicalTrials.gov: NCT03830190. Registered February 5, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03830190.

scholarly journals Evaluating the cost-effectiveness of an early detection of Parkinson's disease through innovative technology

2017 ◽  
Vol 62 (2) ◽  
pp. 180-196 ◽  
Author(s):  
David A. Muñoz ◽  
Mehmet Serdar Kilinc ◽  
Harriet B. Nembhard ◽  
Conrad Tucker ◽  
Xuemei Huang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Early Detection ◽  
Innovative Technology ◽  
The Cost

scholarly journals Pharmacoeconomic comparison of losartan and amlodipine in patients of hypertension in a tertiary care teaching hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 552
Author(s):  
Iram Shaifali ◽  
H. K. Singh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Pharmacoeconomic Analysis ◽  
Tertiary Care ◽  
Cost Effective ◽  
Mean Blood Pressure ◽  
Open Label ◽  
Compliance Cost ◽  
Hypertensive Patients ◽  
The Cost

Background: To conduct a pharmacoeconomic comparison (cost-effectiveness analysis) and to evaluate the overall safety and efficacy of Losartan and Amlodipine in reducing the Mean blood pressure per mm Hg in hypertensive patients.Methods: This was a prospective, randomized, open label, observational analysis of cost-effectiveness; into compare the cost of Losartan 50mg and Amlodipine 5mg in hypertensive patients using either of the two drugs. A total of 80 newly diagnosed drug naïve hypertensive patients were considered for the comparison, of which 40 patients were prescribed Losartan and the other 40 were prescribed Amlodipine as per the recommended dosage. Based on the data, statistical analysis was carried out using SPSS Software Version 21.Results: The two drugs were found to be equi-effective in reducing the blood pressure to the target goal, at their respective equivalent doses Moreover, the cost of reducing 1 mm of Hg mean blood pressure with Losartan was 103.42 INR, whereas that of Amlodipine was 57.11 INR. Hence the cost incurred in treating elevated BP was markedly lower with the Amlodipine group as compared to the Losartan group.Conclusions: This pharmacoeconomic analysis shows that Amlodipine is more cost-effective as compared to Losartan when the cost per mm Hg reduction in mean blood pressure is considered. Hence in India, where the cost of drug is a significant deterrant to patient compliance, cost-effective therapy of chronic disease like hypertension is of prime importance.

scholarly journals Экономическая эффективность доклинической диагностики болезни Паркинсона: марковская модель

2020 ◽  
pp. 129-148
Author(s):  
Сергей Вартанов ◽  
Ирина Богатова ◽  
Ирина Денисова ◽  
Валериан Кучеряну ◽  
Наталья Турдыева ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Risk Group ◽  
Pharmacoeconomic Analysis ◽  
Open Data ◽  
Preventive Treatment ◽  
Economic Effects ◽  
Economic Determinants ◽  
Life Years ◽  
The Cost

Работа посвящена фармакоэкономическому анализу результатов внедрения ранней (доклинической) диагностики болезни Паркинсона в России. На основе совокупности социально-экономических детерминант и панели биомаркеров крови может оказаться возможным выделение среди всей популяции «группы риска» людей, с наибольшей вероятностью склонных к возникновению паркинсонизма либо уже больных им на доклинической стадии. Вкупе с традиционно используемым в фармакоэкономике хронических и продолжительных заболеваний подходом, основанным на представлении динамики развития болезни с помощью марковских цепей – дискретных случайных процессов без памяти – это делает возможным анализ экономических эффектов от раннего выявления заболевших и проведения профилактической доклинической терапии. В работе исследована марковская модель болезни Паркинсона, состоящая из восьми состояний – пять состояний, соответствующих стадиям HY1-HY5, два доклинических состояния («группа риска», «продромальное состояние»). Используя в качестве исходных данных для модели вероятности перехода между состояниями и оценки качества жизни, скорректированные с учетом здоровья (HRQoL), опубликованные в ряде работ аффилированных с корпорацией AbbVie исследователей, и рассчитав затраты на терапию на основе открытых данных о стоимости лекарств и процедур на российском рынке (eapteka, apteka.ru, piluli.ru, сайт Минздрава РФ), в работе показано, что за счет внедрения доклинической диагностики и проведения профилактического лечения на доклинических стадиях выявленным пациентам возможно значительно увеличить среднее время дожития (в годах, скорректированных по качеству жизни) по сравнению со стандартной терапией, а средние затраты на одного пациента до конца жизни – значительно снизить. This article contains a pharmacoeconomic analysis of early (preclinical) diagnosis of Parkinson's disease in Russia. Previous works show that using a combination of socio-economic determinants and a panel of blood biomarkers one may distinguish a Parkinsonism-related “risk group” among the entire population. This group consists of people who are most vulnerable to parkinsonism or are already ill, but at the preclinical stage. Together with the approach traditionally used in the pharmacoeconomics of chronic and long-term diseases, based on the representation of the dynamics of the development of the disease using Markov chains - discrete random processes without memory - this makes it possible to analyze the economic effects of early detection of cases and conducting preventive preclinical therapy. The work investigates the Markov model of Parkinson's disease, consisting of nine states - five states corresponding to the stages HY1-HY5, two preclinical states ("risk group", "prodromal state"). We use as the initial data for the model the probability of transition between states and health-adjusted quality of life (HRQoL) estimates, published in a number of works of researchers affiliated with AbbVie Corporation, and calculate the cost of therapy based on open data on the cost of drugs and procedures in Russian market. Moreover, we show that due to the introduction of preclinical diagnostics and preventive treatment at preclinical stages, identified patients can significantly increase the average survival time (in quality-adjusted life-years) compared to standard therapy, and the average cost per patient until the end of life can be significantly reduced.

V35 The cost-effectiveness of deep brain stimulation for Parkinson’s disease

Basal Ganglia ◽  
2011 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
J. Dams ◽  
B. Bornschein ◽  
U. Siebert ◽  
J. Volkmann ◽  
G. Deuschl ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
The Cost ◽  
Deep Brain

scholarly journals PND17 THE COST-EFFECTIVENESS OF DEEP BRAIN STIMULATION IN PARKINSON'S DISEASE PATIENTS

2009 ◽  
Vol 12 (7) ◽  
pp. A368
Author(s):  
J Dams ◽  
U Siebert ◽  
B Bornschein ◽  
J Volkmann ◽  
G Deuschl ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
The Cost ◽  
Deep Brain
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