Rt. Scheife et al., Impact of Parkinson's disease and its pharmacologic treatment on quality of life and economic outcomes, AM J HEAL S, 57(10), 2000, pp. 953-962
The impact of Parkinson's disease (PD) and its pharmacologic treatment on h
ealth-related quality of life (HRQL) and economic outcomes is reviewed.
PD is a chronic and progressive neurologic disorder characterized by specif
ic motor deficits resulting from the degeneration of dopaminergic neurons i
n the substantia nigra. The cardinal symptoms are tremor, rigidity, bradyki
nesia, and loss of postural reflexes. PD markedly reduces HRQL and places a
n economic burden on society of up to $25 billion per year. Patients' inabi
lity to move freely and to perform everyday tasks restricts their independe
nce and leads to increased reliance on caregivers and assistive devices. Em
otional and psychosocial well-being is also negatively affected. As the dis
ease progresses, the response to levodopa typically decreases and various m
otor complications develop; these are difficult to treat and result in furt
her declines in HRQL. The economic costs of PD include both direct health c
are costs (for drugs, physician services, and hospitalization) and indirect
costs (for lost workers productivity). Economic analyses of PD and its tre
atments can help guide effective allocation of health care resources. Vario
us antiparkinson agents and formulations, such as extended-release levodopa
-carbidopa and pramipexole, have been found to be cost-effective relative t
o other agents. The newest antiparkinsonian drugs, cathechol-O-methyltransf
erase inhibitors, also have the potential to improve HRQL and economic outc
omes, although more study is needed to confirm this.
The total impact of PD and its treatment can be fully appreciated only when
HRQL and economic outcomes, in addition to clinical outcomes, are examined
.