Real-world assessment of “OFF” episode–related healthcare resource utilization among patients with Parkinson’s disease in the United States

作者：Andrew Thach, Eddie Jones, Eric J. Pappert, James Pike, Jack Wright, Alexander Gillespie · 发表于：Journal of Medical Economics · 年份：2021 · DOI：10.1080/13696998.2021.1913009 · 被引用次数：10 · 研究领域：Parkinson's Disease Mechanisms and Treatments、Medication Adherence and Compliance、Balance, Gait, and Falls Prevention

Aims Within 5 years of initiating carbidopa/levodopa, ∼50% of patients with Parkinson’s disease (PD) experience “OFF” episodes; little is known about the cost burden. We investigated the association of “OFF” episodes with patient characteristics, healthcare resource utilization (HCRU), and healthcare costs.Methods Analyses used neurologist-provided data from the US-specific 2017 and 2019 Adelphi Real World Disease Specific Programme for PD, including duration of “OFF” episodes and HCRU for 10–12 consecutive patients. Patients were grouped by presence/absence of “OFF” episodes and by average hours of daily “OFF” time. Between-group differences were assessed for demographics, personal circumstances, and clinical characteristics. Regression analyses modeled the relationship of “OFF” episodes with HCRU and costs.Results Of 1,309 patients, 41% experienced “OFF” episodes, 25% of whom were “OFF” ≥4 h/day. Patients having “OFF” episodes had more severe PD, were diagnosed for longer, and were younger than those without “OFF” (p < .0001). “OFF” episodes were associated with a greater number of prescribed PD drugs (p < .0001). Patients without “OFF” episodes were more likely to have full-time employment and less likely to be retired or unemployed because of PD (p < .001). Patients with and without “OFF” episodes had different living situations (p < .001): patients experiencing “OFF” were less likely to live alone and more likely to live in a nursing home and have a professional caregive...