Christopher Kruse1, Sabrina Kretschmer1,2, Anna Lipinski1,2, Malte Verheyen1, David Mengel3, Monika Balzer-Geldsetzer1,2, Stefan Lorenzl4,5, Carmen Richinger5, Christian Schmotz5, Lars Tönges6,7, Dirk Woitalla8, Stephan Klebe9, Anette Schrag10, Richard Dodel11,12. 1. Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany. 2. Department of Neurology, Philipps-University Marburg, Marburg, Germany. 3. Department of Neurodegenerative Diseases, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. 4. Department of Neurology, Ludwig-Maximilians University, Munich, Germany. 5. Krankenhaus Agatharied GmbH, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria. 6. Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany. 7. Neurodegeneration Research, Centre for Protein Diagnostics (ProDi), Ruhr-University, Bochum, Germany. 8. Department of Neurology, St. Josef-Krankenhaus Kupferdreh, Essen, Germany. 9. Department of Neurology, Essen University Hospital, Essen, Germany. 10. Department of Neurology, King's College, London, UK. 11. Department of Geriatric Medicine, University of Duisburg-Essen, Germaniastrasse 1-3, 45356, Essen, Germany. richard.dodel@uk-essen.de. 12. Department of Neurology, Philipps-University Marburg, Marburg, Germany. richard.dodel@uk-essen.de.
Abstract
OBJECTIVE: The Care of Late-Stage Parkinsonism (CLaSP) study aimed to collect qualitative and standardized patient data in six European countries (France, Germany, Netherlands, Portugal, UK, Sweden) to enable a detailed evaluation of the underexplored late stages of the disease (Hoehn and Yahr stage > 3) using clinical, neuropsychological, behavioral, and health economic data. The aim of this substudy was to provide a health economic evaluation for the German healthcare system. METHODS: In Germany, 228 patients were included in the study. Costs were calculated from a societal perspective for a 3-month period. Univariate analyses were performed to identify cost-driving predictors. Total and direct costs were analyzed using a generalized linear model with a γ-distributed dependent variable and log link function. Indirect costs were analyzed using a binomial generalized linear model with probit link function. RESULTS: The mean costs for the 3-month period were approximately €20,000. Informal care costs and hospitalization are approximately €11,000 and €5000. Direct costs amounted to 89% of the total costs, and the share of indirect costs was 11%. Independent predictors of total costs were the duration of the disease and age. The duration of the disease was the main independent predictor of direct costs, whereas age was an independent predictor of indirect costs. DISCUSSION: Costs in the late stage of the disease are considerably higher than those found in earlier stages. Compared to the latter, the mean number of days in hospital and the need for care is increasing. Informal caregivers provide most of the care. CLINICAL TRIAL REGISTRATION: The protocol was registered at ClinicalTrials.gov as NCT02333175 on 7 January, 2015.
OBJECTIVE: The Care of Late-Stage Parkinsonism (CLaSP) study aimed to collect qualitative and standardized patient data in six European countries (France, Germany, Netherlands, Portugal, UK, Sweden) to enable a detailed evaluation of the underexplored late stages of the disease (Hoehn and Yahr stage > 3) using clinical, neuropsychological, behavioral, and health economic data. The aim of this substudy was to provide a health economic evaluation for the German healthcare system. METHODS: In Germany, 228 patients were included in the study. Costs were calculated from a societal perspective for a 3-month period. Univariate analyses were performed to identify cost-driving predictors. Total and direct costs were analyzed using a generalized linear model with a γ-distributed dependent variable and log link function. Indirect costs were analyzed using a binomial generalized linear model with probit link function. RESULTS: The mean costs for the 3-month period were approximately €20,000. Informal care costs and hospitalization are approximately €11,000 and €5000. Direct costs amounted to 89% of the total costs, and the share of indirect costs was 11%. Independent predictors of total costs were the duration of the disease and age. The duration of the disease was the main independent predictor of direct costs, whereas age was an independent predictor of indirect costs. DISCUSSION: Costs in the late stage of the disease are considerably higher than those found in earlier stages. Compared to the latter, the mean number of days in hospital and the need for care is increasing. Informal caregivers provide most of the care. CLINICAL TRIAL REGISTRATION: The protocol was registered at ClinicalTrials.gov as NCT02333175 on 7 January, 2015.
Authors: Anders Gustavsson; Mikael Svensson; Frank Jacobi; Christer Allgulander; Jordi Alonso; Ettore Beghi; Richard Dodel; Mattias Ekman; Carlo Faravelli; Laura Fratiglioni; Brenda Gannon; David Hilton Jones; Poul Jennum; Albena Jordanova; Linus Jönsson; Korinna Karampampa; Martin Knapp; Gisela Kobelt; Tobias Kurth; Roselind Lieb; Mattias Linde; Christina Ljungcrantz; Andreas Maercker; Beatrice Melin; Massimo Moscarelli; Amir Musayev; Fiona Norwood; Martin Preisig; Maura Pugliatti; Juergen Rehm; Luis Salvador-Carulla; Brigitte Schlehofer; Roland Simon; Hans-Christoph Steinhausen; Lars Jacob Stovner; Jean-Michel Vallat; Peter Van den Bergh; Peter Van den Bergh; Jim van Os; Pieter Vos; Weili Xu; Hans-Ulrich Wittchen; Bengt Jönsson; Jes Olesen Journal: Eur Neuropsychopharmacol Date: 2011-09-15 Impact factor: 4.600
Authors: K Ray Chaudhuri; A Simon Pickard; Ali Alobaidi; Yash J Jalundhwala; Prasanna L Kandukuri; Yanjun Bao; Julia Sus; Glynn Jones; Christian Ridley; Julia Oddsdottir; Seyavash Najle-Rahim; Matthew Madin-Warburton; Weiwei Xu; Anette Schrag Journal: Pharmacoeconomics Date: 2022-03-21 Impact factor: 4.558