, Volume 27, Issue 7, pp 571–584

Costs of Illness in a Russian Cohort of Patients with Parkinson’s Disease

  • Yaroslav Winter
  • Sonja von Campenhausen
  • Georgy Popov
  • Jens P. Reese
  • Jens Klotsche
  • Kai Bötzel
  • Eugene Gusev
  • Wolfgang H. Oertel
  • Richard Dodel
  • Alla Guekht
Original Research Article


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 h2620 (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.


  1. 1.
    Von Campenhausen S, Bornschein B, Wick R, et al. Prevalence and incidence of Parkinson’s disease in Europe. Eur Neuropsychopharmacol 2005; 15: 473–90CrossRefGoogle Scholar
  2. 2.
    Dorsey ER, Constantinescu R, Thompson JP, et al. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 2007; 68 (5): 384–6PubMedCrossRefGoogle Scholar
  3. 3.
    Golbe L. The epidemiology of Parkinson’s disease. In: LeWitt P, Oertel W, editors. Parkinson’s disease: the treatment options. London: Martin Dunitz, 1999: 63–78Google Scholar
  4. 4.
    de Rijk MC, Tzourio C, Breteler MMB, et al. Prevalence of parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON collaborative study. J Neurol Neurosurg Psychiatry 1997; 62: 10–5PubMedCrossRefGoogle Scholar
  5. 5.
    Dodel RC, Singer M, Kohne-Volland R, et al. The economic impact of Parkinson’s disease: an estimation based on a 3-month prospective analysis. Pharmacoeconomics 1998; 14 (3): 299–312PubMedCrossRefGoogle Scholar
  6. 6.
    Lindgren P, Von Campenhausen S, Spottke AE, et al. Cost of Parkinson’s disease in Europe. Eur J Neurol 2005; 12 Suppl. 1: 68–73PubMedCrossRefGoogle Scholar
  7. 7.
    Rubenstein LM, Chrischilles EA, Voelker MD. The impact of Parkinson’s disease on health status, health expenditures, and productivity: estimates from the National Medical Expenditure Survey. Pharmacoeconomics 1997; 12 (4): 486–98PubMedCrossRefGoogle Scholar
  8. 8.
    Whetten-Goldstein K, Sloan F, Kulas E, et al. The burden of Parkinson’s disease on society, family, and the individual. J Am Geriatr Soc 1997; 45 (7): 844–9PubMedGoogle Scholar
  9. 9.
    Hagell P, Nordling S, Reimer J, et al. Resource use and costs in a Swedish cohort of patients with Parkinson’s disease. Mov Disord 2002; 17: 1213–20PubMedCrossRefGoogle Scholar
  10. 10.
    Huse DM, Schulman K, Orsini L, et al. Burden of illness in Parkinson’s disease. Mov Disord 2005; 20 (11): 1449–54PubMedCrossRefGoogle Scholar
  11. 11.
    Guttman M, Slaughter PM, Theriault ME, et al. Burden of parkinsonism: a population-based study. Mov Disord 2003; 18: 313–36PubMedCrossRefGoogle Scholar
  12. 12.
    Keranen T, Kaakkola S, Sotaniemi K. Economic burden and quality of life impairment increase with severity of PD. Parkinsonism Relat Disord 2003; 9: 163–8PubMedCrossRefGoogle Scholar
  13. 13.
    LePen C, Wait S, Moutard-Martin F, et al. Cost of illness and disease severity in a cohort of French patients with Parkinson’s disease. Pharmacoeconomics 1999; 16: 59–69PubMedCrossRefGoogle Scholar
  14. 14.
    Noyes K, Liu H, Li Y, et al. Economic burden associated with Parkinson’s disease on elderly Medicare beneficiaries. Mov Disord 2006; 21 (3): 362–72PubMedCrossRefGoogle Scholar
  15. 15.
    Spottke AE, Reuter M, Machat O, et al. Cost of illness and its predictors for Parkinson’s disease in Germany. Pharmacoeconomics 2005; 23: 817–36PubMedCrossRefGoogle Scholar
  16. 16.
    Ragothaman M, Govindappa ST, Rattihalli R, et al. Direct costs of managing Parkinson’s disease in India: concerns in a developing country. Mov Disord 2006; 21 (10): 1755–8PubMedCrossRefGoogle Scholar
  17. 17.
    Wang G, Cheng Q, Zheng R, et al. Economic burden of Parkinson’s disease in a developing country: a retrospective cost analysis in Shanghai, China. Mov Disord 2006; 21 (9): 1439–43PubMedCrossRefGoogle Scholar
  18. 18.
    Gibb WRG. Accuracy in the clinical diagnosis of parkinsonian syndromes. Postgrad Med J 1988; 64: 345–512PubMedCrossRefGoogle Scholar
  19. 19.
    Martinez-Martin P, Gil-Nagel A, Gracia LM, et al. Unified Parkinson’s Disease Rating Scale characteristics and structure. The Cooperative Multicentric Group. Mov Disord 1994; 9 (1): 76–83PubMedCrossRefGoogle Scholar
  20. 20.
    Hoehn MM, Yahr M. Parkinsonism: onset, progression and mortality. Neurology 1967; 5: 427–42CrossRefGoogle Scholar
  21. 21.
    Beck A, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Ger Psychiatry 1961; 4: 561–7CrossRefGoogle Scholar
  22. 22.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (3): 189–98PubMedCrossRefGoogle Scholar
  23. 23.
    The EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199–208CrossRefGoogle Scholar
  24. 24.
    Russian State Committee for Statistics [online]. Available from URL: [Accessed 2008 Oct 10]
  25. 25.
    Bereau of Economic Analysis of Russia [online]. Available from URL: [Accessed 2007 Jan 20]
  26. 26.
    Official state price list of drugs for 2005. Moscow: Ministry Public Health and Social Development of Russian Federation, 2005Google Scholar
  27. 27.
    Official reimbursement list of drugs in Russian Federation. Moscow: Ministry Public Health and Social Development of Russian Federation, 2005Google Scholar
  28. 28.
    Official tariff list for medical services. Moscow: Ministry Public Health and Social Development of Russian Federation, 2005Google Scholar
  29. 29.
    Catalogue of company “Med-Magazin” Ltd. Moscow: “Med-Magazin” Ltd, 2005Google Scholar
  30. 30.
    Catalogue of company “SIMS-2” Ltd. Moscow: “SIMS-2” Ltd, 2005Google Scholar
  31. 31.
    Russian State Committee for Statistics [online]. Available from URL: [Accessed 2007 Jan 20]
  32. 32.
    Gold MR, Siegel JE, Russell LB, et al. Cost-effectiveness in health and medicine. New York (NY): Oxford University Press, 1996Google Scholar
  33. 33.
    Russian State Committee for Statistics [online]. Available from URL: [Accessed 2007 Jan 20]
  34. 34.
    Barber JA, Thompson SG. Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med 2000; 19: 3219–36PubMedCrossRefGoogle Scholar
  35. 35.
    Efron B, Tibshirani RJ. An introduction to the bootstrap. London: Chapman and Hall, 1993Google Scholar
  36. 36.
    Carpenter J, Bithell J. Bootstrap confidence intervals: when, which, what? A practical guide for medical statisticians. Stat Med 2000; 19: 1141–64PubMedCrossRefGoogle Scholar
  37. 37.
    Andlin-Sobocki P, Jonsson B, Wittchen HU, et al. Costs of disorders of the brain in Europe. Eur J Neurol 2005; 12 (Suppl. 1): 1–27PubMedCrossRefGoogle Scholar
  38. 38.
    Findley L, Aujla M, Bain PG, et al. Direct economic impact of Parkinson’s disease: a research survey in the United Kingdom. Mov Disord 2003; 18: 1139–45PubMedCrossRefGoogle Scholar
  39. 39.
    Haycock J. Idiopathic Parkinson’s disease: the burden of illness [dissertation]. York: University of York, 1992Google Scholar
  40. 40.
    Kemper P. The use of formal and informal home care by the disabled elderly. Health Serv 1992; 27 (4): 421–51Google Scholar
  41. 41.
    Nordberg G, Von Strauss E, Kareholt I, et al. The amount of informal and formal care among non-demented and demented elderly persons: results from a Swedish population-based study. Int J Geriatr Psychiatry 2005; 20 (9): 862–71PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Yaroslav Winter
    • 1
    • 2
  • Sonja von Campenhausen
    • 1
    • 3
  • Georgy Popov
    • 4
  • Jens P. Reese
    • 1
  • Jens Klotsche
    • 5
  • Kai Bötzel
    • 3
  • Eugene Gusev
    • 4
  • Wolfgang H. Oertel
    • 1
  • Richard Dodel
    • 1
  • Alla Guekht
    • 4
  1. 1.Department of NeurologyPhilipps University MarburgMarburgGermany
  2. 2.Center for Mental Health, Klinikum StuttgartEberhard-Karls-UniversityTübingenGermany
  3. 3.Department of NeurologyLudwig-Maximilians-UniversityMunichGermany
  4. 4.Department of NeurologyRussian Medical State UniversityMoscowRussia
  5. 5.Department of Psychology and PsychotherapyTechnical UniversityDresdenGermany

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