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Health State Values during the First Year of Drug Treatment in Early-Stage Parkinson’s Disease

A Prospective, Population-Based, Cohort Study

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Abstract

Background: Parkinson’s disease (PD) is a common neurodegenerative disorder in the elderly that may lead to both motor and non-motor symptoms with consequent severe impairment of quality of life. PD also represents a substantial economic burden on society because of the patient’s decreased ability to work, increased need for care and need for costly treatment. Evaluation of quality-adjusted life-years (QALYs) is an important tool in cost-effectiveness analyses. To date, however, few data have become available about the utility gains or losses associated with the disease and its management.

Objectives: To evaluate the changes in health state values in patients with newly diagnosed PD during their first year of drug treatment, and to calculate the gain in QALYs and the incremental cost-effectiveness ratio (ICER) for this patient group.

Methods: In this prospective, population-based, cohort study, 199 patients with incident PD and 172 controls were followed over 1 year. Clinical data, drug use and utility scores obtained from the Short Form 6D (SF-6D) health state questionnaire were documented.

Results: Patients with PD had lower SF-6D utility scores than controls at baseline. Patients started on antiparkinsonian drugs had an improvement in mean utility scores of 0.039 from 0.667 to 0.706 (p<0.05). The ICER was h45 259 (2007 values) per QALY, of which two-thirds consisted of the costs of drugs and one-third represented the costs of clinical consultations.

Conclusion: Drug treatment in patients with early-stage PD increases health state values, but the ICER is high. Further investigations will be necessary to capture the full consequences of treatment of PD and to evaluate the efficacy of disease management in this setting.

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Acknowledgements

The clinical data applied in this study were collected by the Norwegian ParkWest Study Group. We thank John Brazier at Health Economics and Decision Science, University of Sheffield, UK, for his kind advice in generating the utility scores and in executing the study. We thank the Lars Kristian Sundseths Legat for its financial support. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Neurology, Stavanger University Hospital, Box 8100, N-4068, Stavanger, Norway

    Corinna Vossius & Jan Petter Larsen

  2. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway

    Corinna Vossius, Odd Bjarte Nilsen & Jan Petter Larsen

  3. Stokka Teaching Nursing Home, Stavanger, Norway

    Corinna Vossius

  4. Department of Mathematics and Natural Science, University of Stavanger, Stavanger, Norway

    Odd Bjarte Nilsen

  5. Institute of Medicine, University of Bergen, Bergen, Norway

    Jan Petter Larsen

Authors
  1. Corinna Vossius
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  2. Odd Bjarte Nilsen
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  3. Jan Petter Larsen
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Correspondence to Corinna Vossius.

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Vossius, C., Nilsen, O.B. & Larsen, J.P. Health State Values during the First Year of Drug Treatment in Early-Stage Parkinson’s Disease. Drugs Aging 26, 973–980 (2009). https://doi.org/10.2165/11318750-000000000-00000

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  • DOI: https://doi.org/10.2165/11318750-000000000-00000

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