Budget Impact analysis of a new system of care in Parkinson’s disease patients
DOI:
https://doi.org/10.33393/grhta.2022.2413Keywords:
Apomorphine hydrochloride, Budget Impact Analysis, Economic Evaluation, Parkinson’s DiseaseAbstract
Objective: To estimate the economic impact of the introduction of a new care system based on apomorphine and Patient Support Program for motor fluctuations (“on-off” phenomena) in patients with Parkinson’s disease which are not sufficiently controlled by oral anti-Parkinson medication in Italy.
Method: A Budget Impact model was developed to evaluate the new care system in patients with Parkinson’s disease over a 3-years’ time horizon. The comparator treatments included in the analysis were treatments based on apomorphine and levodopa + carbidopa. The analysis was conducted from a National Health Service (NHS) perspective. Costs included in the analysis were acquisition costs and device costs. A deterministic sensitivity analysis was carried out to evaluate the uncertainty of the parameters used. A break-even analysis was conducted to identify the minimum number of subjects that would need to be treated with the new care system to obtain a positive Budget Impact (World With – World Without = 0).
Results: The analysis shows that the introduction of the new care system based on apomorphine could generate a cost saving incurred by the NHS of over € 5.7 million in 3 years. Break-even analysis shows that if it were possible to intercept with the new treatment at least 9 patients treated with apomorphine, there would not be an increase in costs for the NHS.
Conclusion: The new care system would respond to the unmet needs of patients with Parkinson’s disease by generating a reduction in the expenditure incurred by NHS.
Downloads
References
European Parkinson’s Disease Association. What is Parkinson’s disease? Online https://www.epda.eu.com/about-parkinsons/what-is-parkinsons/. Accessed April 2022.
Riccò M, Vezzosi L, Balzarini F, et al. Prevalence of Parkinson Disease in Italy: a systematic review and meta-analysis. Acta Biomed. 2020;91(3):e2020088. PMID:32921784
Torti M, Bravi D, Vacca L, Stocchi F. Are All Dopamine Agonists Essentially the Same? Drugs. 2019;79(7):693-703. https://doi.org/10.1007/s40265-019-01103-2 PMID:30968290
Jenner P, Katzenschlager R. Apomorphine - pharmacological properties and clinical trials in Parkinson’s disease. Parkinsonism Relat Disord. 2016;33(suppl 1):S13-S21. https://doi.org/10.1016/j.parkreldis.2016.12.003 PMID:27979722
Djamshidian A, Poewe W. Apomorphine and levodopa in Parkinson’s disease: two revolutionary drugs from the 1950's. Parkinsonism Relat Disord. 2016;33(suppl 1):S9-S12. https://doi.org/10.1016/j.parkreldis.2016.12.004 PMID:28012951
Ferreira JJ, Lees A, Rocha JF, Poewe W, Rascol O, Soares-da-Silva P; Bi-Park 1 investigators. Opicapone as an adjunct to levodopa in patients with Parkinson’s disease and end-of-dose motor fluctuations: a randomised, double-blind, controlled trial. Lancet Neurol. 2016;15(2):154-165. https://doi.org/10.1016/S1474-4422(15)00336-1 PMID:26725544
Katzenschlager R, Poewe W, Rascol O, et al. Apomorphine subcutaneous infusion in patients with Parkinson’s disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Neurol. 2018;17(9):749-759. https://doi.org/10.1016/S1474-4422(18)30239-4 PMID:30055903
Olanow CW, Kieburtz K, Odin P, et al; LCIG Horizon Study Group. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson’s disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol. 2014;13(2):141-149. https://doi.org/10.1016/S1474-4422(13)70293-X PMID:24361112
Mauskopf JA, Sullivan SD, Annemans L, et al. Principles of good practice for budget impact analysis: report of the ISPOR Task Force on good research practices--budget impact analysis. Value Health. 2007;10(5):336-347. https://doi.org/10.1111/j.1524-4733.2007.00187.x PMID:17888098
Sullivan SD, Mauskopf JA, Augustovski F, et al. Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014;17(1):5-14. https://doi.org/10.1016/j.jval.2013.08.2291 PMID:24438712
Stefani A, Tessitore A, Tambasco N, et al. Criteria for identification of advanced Parkinson’s disease: the results of the Italian subgroup of OBSERVE-PD observational study. BMC Neurol. 2022;22(1):41. https://doi.org/10.1186/s12883-022-02554-z PMID:35090406
von Campenhausen S, Winter Y, Rodrigues e Silva A, et al. Costs of illness and care in Parkinson’s disease: an evaluation in six countries. Eur Neuropsychopharmacol. 2011;21(2):180-191. https://doi.org/10.1016/j.euroneuro.2010.08.002 PMID:20888737
Yang W, Hamilton JL, Kopil C, et al. Current and projected future economic burden of Parkinson’s disease in the U.S. NPJ Parkinsons Dis. 2020;6(1):15. https://doi.org/10.1038/s41531-020-0117-1 PMID: 32665974
ISTAT. Popolazione residente al 1 gennaio 2022. Online https://demo.istat.it/popres/index.php?anno=2022&lingua=ita. Accessed April 2022
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 The authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to Global & Regional Health Technology Assessment agree to publish their articles under the CC-BY-NC 4.0 license, which allows third parties to re-use the work without permission as long as the work is properly referenced and the use is non-commercial.
Accepted 2022-07-28
Published 2023-01-20