Costs of Parkinson's disease in eastern Europe: a Czech cohort study.

Life expectancy is increasing worldwide and the burden of Parkinson's disease (PD) is growing. There are several cost-of-illness studies for PD from Western Europe and the USA, however, data about the costs associated with PD in Eastern Europe are still lacking. The objective of this study was to evaluate direct and indirect costs in a cohort of Czech patients with idiopathic PD and to identify cost-driving factors. Study participants (n=100) were recruited from the neurological department of the Charles University in Prague. Health-economic data were collected using a "bottom-up" approach. Costs were calculated from the societal perspective and the human capital approach was used to estimate indirect costs. Czech currency was converted into 2004 Euros (EUR) and inflated to 2008 prices. Independent cost-driving factors were identified in multivariate regression analysis. Total semi-annual costs of PD were EUR 5510 (95% CI: 4470-7090) per patient. Direct costs accounted for 60% of the total costs and indirect costs for 40%. Patients' expenditures accounted for 40% of their income. Independent cost-driving factors included disease severity, motor complications, psychosis and age. In conclusion, our study demonstrates a considerable economic burden of PD in the Czech Republic. Total costs are generally lower than in Western Europe but the proportion of costs that fall on patients is higher because of lower incomes. More intensive government support for patients with chronic diseases such as PD and the development of disease-management programs that incorporate both the clinical and economic effects of PD treatment are needed.