Assessing healthcare resource utilization burden and unmet treatment needs in patients with Parkinson’s disease: results from a real-world study
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: Current Parkinson’s disease (PD) research evaluates patients with early and severe PD, but often overlooks patients with intermediate PD. This study aims to quantify unmet treatment needs, disease burden and healthcare resource utilization among patients with PD within different Hoehn and Yahr stage groups in the US. Materials & methods: Data were drawn from the Adelphi Parkinson’s Disease Specific Programme™, a cross-sectional survey of physicians and their patients in the US from September 2021 to April 2022. Patients were staged as early (Hoehn and Yahr stage 1–2), intermediate (stage 2.5–3) or severe (stage 4–5) PD. Analyses compared PD stages, focusing on the intermediate group. Results: Ninety-five physicians provided data for 1251 patients; 47.4%, 40.4%, and 12.2% were early-, intermediate-, and severe-stage PD, respectively. Mean age was 65.1, 71.8, and 77.8 years and mean time since diagnosis was 2.5, 5.1, and 7.7 years (p < 0.001) across early, intermediate, and severe groups, respectively. The mean number of products used in current regimen was 1.1 for early, 1.9 for intermediate and 2.4 for severe groups. The intermediate versus early group had a significantly greater proportion of patients with unmet treatment needs (p < 0.001), e.g., slowing disease progression, providing neuroprotection. Incidence rate ratios were increased for the intermediate versus early group for number (in previous 12 months) of healthcare professionals involved in patients’ PD management (incidence rate ratios 1.1), healthcare professional consultations (1.4), emergency room visits (3.8) and rehabilitation admissions (6.8). Patient-reported quality of life was significantly poorer in the intermediate versus early group. Conclusion: This real-world analysis found significant increases in disease burden and healthcare resource utilization for patients with intermediate versus early PD. More effective intervention of patients at intermediate-stage PD may improve symptom control and decrease the PD burden for patients and the healthcare system.
Plain language summary: A survey of patients with Parkinson’s disease to assess use of healthcare resources & current treatment needs
What is this article about?
This study looked at the burden of Parkinson’s disease (PD) on patients and the healthcare system in the US. Early, intermediate and severe stages of the disease were compared.
What were the results?
There were significant increases in disease burden and healthcare resource use for patients with intermediate PD compared with patients with early PD.
What do the results mean?
More effective intervention of patients at intermediate-stage PD may delay the transition to severe PD, improve symptom control and decrease the PD burden for patients and the healthcare system.
Supplementary Material
References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
Kalia LV, Lang AE. Parkinson's disease. Lancet 386(9996), 896–912 (2015).
2.
Kouli A, Torsney KM, Kuan WL. Chapter 1: Parkinson's disease: etiology, neuropathology, and pathogenesis. In: Parkinson's Disease: Pathogenesis and Clinical Aspects. Stoker TB, Greenland JC (Eds). Codon Publications, Australia (2018).
3.
Ou Z, Pan J, Tang S et al. Global trends in the incidence, prevalence, and years lived with disability of Parkinson's disease in 204 countries/territories from 1990 to 2019. Front. Public Health 9, 776847 (2021).
4.
US Neurological Disorders Collaborators; Feigin VL, Vos T, Alahdab F et al. Burden of neurological disorders across the US from 1990–2017: a Global Burden of Disease study. JAMA Neurol. 78(2), 165–176 (2021).
5.
Dahodwala N, Li P, Jahnke J et al. Burden of Parkinson's disease by severity: health care costs in the U.S. medicare population. Mov. Disord. 36(1), 133–142 (2021).
6.
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. 6, 15 (2020).
• Analyzes the economic burdens of Parkinson’s disease in the US (2017) and projections for the next two decades, with findings underscoring the substantial burden of PD to society, payers, patients and caregivers.
7.
World Health Organization. Parkinson disease. A public health approach. Technical brief. World Health Organization, Switzerland (2022).
8.
Balestrino R, Schapira AHV. Parkinson disease. Eur. J. Neurol. 27(1), 27–42 (2020).
9.
Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson's disease. Lancet Neurol. 20(5), 385–397 (2021).
10.
Postuma RB, Berg D, Adler CH et al. The new definition and diagnostic criteria of Parkinson's disease. Lancet Neurol. 15(6), 546–548 (2016).
11.
Tysnes OB, Storstein A. Epidemiology of Parkinson's disease. J. Neural. Transm. (Vienna) 124(8), 901–905 (2017).
12.
Lotankar S, Prabhavalkar KS, Bhatt LK. Biomarkers for Parkinson's disease: recent advancement. Neurosci. Bull. 33(5), 585–597 (2017).
13.
Zahoor I, Shafi A, Haq E. Chapter 7: pharmacological treatment of Parkinson's disease. In: Parkinson's Disease: Pathogenesis and Clinical Aspects. Stoker TB, Greenland JC (Eds). Codon Publications, Australia (2018).
14.
Halli-Tierney AD, Luker J, Carroll DG. Parkinson disease. Am. Fam. Physician 102(11), 679–691 (2020).
• Provides a comprehensive overview of PD and its treatment.
15.
LeWitt PA, Chaudhuri KR. Unmet needs in Parkinson disease: motor and non-motor. Parkinsonism Relat. Disord. 80(Suppl. 1), S7–S12 (2020).
16.
Lees A, Tolosa E, Stocchi F et al. Optimizing levodopa therapy, when and how? Perspectives on the importance of delivery and the potential for an early combination approach. Expert Rev. Neurother. 23(1), 15–24 (2023).
• Discusses the evidence for current levodopa optimization strategies during early disease and once motor complications have started. It reaffirms levodopa as the cornerstone of antiparkinsonian therapy and suggests patients would benefit from earlier use of low doses of several agents.
17.
Vanle B, Olcott W, Jimenez J et al. NMDA antagonists for treating the non-motor symptoms in Parkinson's disease. Transl. Psychiatry 8(1), 117 (2018).
18.
Cenci MA, Skovgård K, Odin P. Non-dopaminergic approaches to the treatment of motor complications in Parkinson's disease. Neuropharmacology 210, 109027 (2022).
19.
van den Heuvel L, Evers LJW, Meinders MJ et al. Estimating the effect of early treatment initiation in Parkinson's disease using observational data. Mov. Disord. 36, 407–414 (2021).
20.
Pagano G, Taylor KI, Anzures-Cabrera J et al. Trial of prasinezumab in early-stage Parkinson's disease. N. Engl. J. Med. 387(5), 421–432 (2022).
21.
Hacker ML, Turchan M, Heusinkveld LE et al. Deep brain stimulation in early-stage Parkinson disease: five-year outcomes. Neurology 95(4), e393–e401 (2020).
22.
Chaudhuri KR, Titova N. Societal burden and persisting unmet needs of Parkinson's disease. Eur. Neurol. Rev. 14(1), 28–35 (2019).
• Presents the current and future societal burden of PD and the unmet needs in PD, and the efforts and progress made to resolve them.
23.
Goetz CG, Poewe W, Rascol O et al. Movement disorder society task force on rating scales for Parkinson's Disease. Movement disorder society task force report on the Hoehn and Yahr staging scale: status and recommendations. Mov. Disord. 19(9), 1020–1028 (2004).
24.
Bhidayasiri R, Tarsy D. Parkinson's disease: Hoehn and Yahr scale. In: Movement Disorders: A Video Atlas. Humana Totowa, USA, p4–5 (2012).
25.
Anderson P, Benford M, Harris N, Karavali M, Piercy J. Real-world physician and patient behaviour across countries: disease-specific programmes – a means to understand. Curr. Med. Res. Opin. 24(11), 3063–3072 (2008).
26.
Anderson P, Higgins V, Courcy J et al. Real-world evidence generation from patients, their caregivers and physicians supporting clinical, regulatory and guideline decisions: an update on Disease Specific Programmes. Curr. Med. Res. Opin. 39(12), 1707–1715 (2023).
27.
Babineaux SM, Curtis B, Holbrook T, Milligan G, Piercy J. Evidence for validity of a national physician and patient-reported, cross-sectional survey in China and UK: the disease specific programme. BMJ Open 6(8), e010352 (2016).
28.
Higgins V, Piercy J, Roughley A et al. Trends in medication use in patients with Type 2 diabetes mellitus: a long-term view of real-world treatment between 2000 and 2015. Diabetes Metab. Syndr. Obes. 9, 371–380 (2016).
29.
Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual. Life Res. 4(3), 241–248 (1995).
30.
EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16(3), 199–208 (1990).
31.
EuroQol Research Foundation. EQ-5D-5L User Guide.v3 2019. EuroQol Research Foundation, Rotterdam, The Netherlands (2021).Available from: https://euroqol.org/publications/user-guides/
32.
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a Work Productivity and Activity Impairment instrument. Pharmacoeconomics 4(5), 353–365 (1993).
33.
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20(6), 649–655 (1980).
34.
European Pharmaceutical Market Research Association (EPHMRA). Code of Conduct. (2020). Available from: https://www.ephmra.org/media/4857/ephmra-2020-code-of-conduct-final.pdf
35.
US Department of Health and Human Services. Summary of the HIPAA Privacy Rule. (2003). Available from: http://www.hhs.gov/sites/default/files/privacysummary.pdf
36.
Health Information Technology (HITECH). Health Information Technology Act. (2009). Available from: https://www.healthit.gov/sites/default/files/hitech_act_excerpt_from_arra_with_index.pdf
37.
Stocchi F, Antonini A, Barone P et al. Early detection of wearing off in Parkinson disease: the DEEP study. Parkinsonism Relat. Disord. 20(2), 204–211 (2014).
38.
Crispo JA, Fortin Y, Thibault DP et al. Trends in inpatient antiparkinson drug use in the USA, 2001–2012. Eur. J. Clin. Pharmacol. 71(8), 1011–1019 (2015).
39.
Brodsky MA, Park BS, Nutt JG. Effects of a dopamine agonist on the pharmacodynamics of levodopa in Parkinson disease. Arch. Neurol. 67(1), 27–32 (2010).
40.
Müller T. Catechol-O-methyltransferase inhibitors in Parkinson's disease. Drugs 75(2), 157–174 (2015).
41.
Zhang Z, Zhang S, Fu P et al. Roles of glutamate receptors in Parkinson's disease. Int. J. Mol. Sci. 20(18), 4391 (2019).
42.
Fargel M, Grobe B, Oesterle E, Hastedt C, Rupp M. Treatment of Parkinson's disease: a survey of patients and neurologists. Clin. Drug Investig. 27(3), 207–218 (2007).
43.
Freitas ME, Hess CW, Fox SH. Motor complications of dopaminergic medications in Parkinson's disease. Semin. Neurol. 37(2), 147–157 (2017).
44.
Rosqvist K, Schrag A, Odin P. The CLaSP Consortium. Caregiver burden and quality of life in late stage Parkinson's disease. Brain Sci. 12(1), 111 (2022).
45.
Zhao N, Yang Y, Zhang L et al. Quality of life in Parkinson's disease: a systematic review and meta-analysis of comparative studies. CNS Neurosci. Ther. 27(3), 270–279 (2021).
46.
Gandhi AB, Onukwugha E, Albarmawi H et al. Health care resource utilization associated with Parkinson disease among Medicare beneficiaries. Neurology 97(6), e597–e607 (2021).
47.
Thach A, Jones E, Pappert E, Pike J, Wright J, Gillespie A. Real-world assessment of “OFF” episode-related healthcare resource utilization among patients with Parkinson's disease in the United States. J. Med. Econ. 24(1), 540–549 (2021).
48.
Serbin M, Odak S, Macahilig C et al. Real-world healthcare resource utilization in patients with Parkinson's disease and motor fluctuations. Mov. Disord. 35(Suppl.1), S142 (2022). Available at: https://www.mdsabstracts.org/abstract/real-world-healthcare-resource-utilization-in-patients-with-parkinsons-disease-and-motor-fluctuations/
49.
DeTora LM, Toroser D, Sykes A et al. Good Publication Practice (GPP) guidelines for company-sponsored biomedical research: 2022 update. Ann. Intern. Med. 175(9), 1298–1304 (2022).
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© 2025 Mitsubishi Tanabe Pharma America, Inc., Jersey City, NJ, USA. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 3 October 2024
Accepted: 13 August 2025
Published online: 23 September 2025
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Assessing healthcare resource utilization burden and unmet treatment needs in patients with Parkinson’s disease: results from a real-world study. (2025) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2024-0186
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