Current and projected future economic burden of Parkinson's disease in the U.S

Abstract

Parkinson's disease (PD) is one of the world's fastest growing neurological disorders. Much is unknown about PD-associated economic burdens in the United States (U.S.) and other high-income nations. This study provides a comprehensive analysis of the economic burdens of PD in the U.S. (2017) and projections for the next two decades. Multiple data sources were used to estimate the costs of PD, including public and private administrative claims data, Medicare Current Beneficiary Survey, Medical Expenditure Panel Survey, and a primary survey (n = 4,548) designed for this study. We estimated a U.S. prevalence of approximately one million individuals with diagnosed Parkinson's disease in 2017 and a total economic burden of $51.9 billion. The total burden of PD includes direct medical costs of $25.4 billion and $26.5 billion in indirect and non-medical costs, including an indirect cost of $14.2 billion (PWP and caregiver burden combined), non-medical costs of $7.5 billion, and $4.8 billion due to disability income received by PWPs. The Medicare program bears the largest share of excess medical costs, as most PD patients are over age 65. Projected PD prevalence will be more than 1.6 million with projected total economic burden surpassing $79 billion by 2037. The economic burden of PD was previously underestimated. Our findings underscore the substantial burden of PD to society, payers, patients, and caregivers. Interventions to reduce PD incidence, delay disease progression, and alleviate symptom burden may reduce the future economic burden of PD.

Keywords: Health care economics; Neurological disorders.

Fig. 1. Total economic burden of Parkinson’s disease in the U.S. in 2017 (in billions).

Pie chart of the economic burden of Parkinson’s disease in the U.S. in 2017 by components (in billion $s).

Fig. 2. Projected number of persons with diagnosed Parkinson’s disease in the U.S. by 2037.

Bar chart of the projected number of persons with Parkinson’s disease in the U.S. by 2037. Authors’ projections by applying PD prevalence estimated for 2017, using 2011–2015 Medical Expenditure Panel Survey (MEPS), 2015 Medicare Current Beneficiary Survey (MCBS), and Census population projections for 2017, to future U.S. population projections from the year 2018–2037. Projections for other years between 2018 and 2037 are available upon request.

Fig. 3. Projected economic burden of Parkinson’s disease in the U.S. by 2037 (billions in 2017 $).

Bar chart of the projected economic burden of Parkinson’s disease in the U.S. by 2037. Authors’ projections by applying estimated 2017 direct medical cost using 2016 Optum claims data, 2015 Medicare Standard Analytical File 5% sample claims, and 2015 MCBS, and the indirect and non-medical costs estimated using data sources such as the CDC WONDER files, BLS earnings data, and responses from the PD Impact Survey, to projected future PD prevalence. Future PD prevalence was estimated by applying PD prevalence in 2017, estimated using 2011–2015 Medical Expenditure Panel Survey (MEPS), 2015 Medicare Current Beneficiary Survey (MCBS), and Census population projections for 2017, to future U.S. population projections from year 2018 to 2037.

Fig. 4. Flow chart of cost calculation and data sources.

Flow chart showing data source and cost calculation steps. Abbreviations: dNHI: Optum de-identified Normative Health Information system; Medicare SAF: Medicare Standard Analytical File; MCBS: Medicare Current Beneficiary Survey; MEPS: Medical Expenditure Panel Survey.