The Social Value of Improvement in Activities of Daily Living among the Advanced Parkinson’s Disease Population

Sullivan Jeffrey, Shih Tiffany M., Emma van Eijndhoven (), Jalundhwala Yash J., Darius Lakdawalla, Zadikoff Cindy, Benner Jennifer, Marshall Thomas S. and Sail Kavita R.
Additional contact information
Sullivan Jeffrey: PRECISIONheor, 11100 Santa Monica Boulevard, Suite 500, Los Angeles, CA 90025, USA
Shih Tiffany M.: PRECISIONheor, 11100 Santa Monica Boulevard, Suite 500, Los Angeles, CA 90025, USA
Emma van Eijndhoven: PRECISIONheor, 11100 Santa Monica Boulevard, Suite 500, Los Angeles, CA 90025, USA
Jalundhwala Yash J.: AbbVie, Health Economics and Outcomes Research, 1 North Waukegan Rd, D-GMH1, AP31-1E, North Chicago, IL 60064, USA
Zadikoff Cindy: AbbVie, Health Economics and Outcomes Research, 1 North Waukegan Rd, D-GMH1, AP31-1E, North Chicago, IL 60064, USA
Benner Jennifer: PRECISIONheor, 11100 Santa Monica Boulevard, Suite 500, Los Angeles, CA 90025, USA
Marshall Thomas S.: AbbVie, Health Economics and Outcomes Research, 1 North Waukegan Rd, D-GMH1, AP31-1E, North Chicago, IL 60064, USA
Sail Kavita R.: AbbVie, Health Economics and Outcomes Research, 1 North Waukegan Rd, D-GMH1, AP31-1E, North Chicago, IL 60064, USA

Forum for Health Economics & Policy, 2020, vol. 23, issue 2, 1-23

Abstract: ObjectivesQuantify the value of functional status (FS) improvements consistent in magnitude with improvements due to levodopa-carbidopa intestinal gel (LCIG) treatment, among the advanced Parkinson’s disease (APD) population.MethodsThe Health Economic Medical Innovation Simulation (THEMIS), a microsimulation that estimates future health conditions and medical spending, was used to quantify the health and cost burden of disability among the APD population, and the value of quality-adjusted life-years gained from FS improvement due to LCIG treatment compared to standard of care (SoC). A US-representative Parkinson’s disease (PD)-comparable cohort was constructed in THEMIS based on observed PD patient characteristics in a nationally representative dataset. APD was defined from the literature and clinical expert input. The PD and APD cohorts were followed from 2010 over their remaining lifetimes. All individuals were ages 65 and over at the start of the simulation. To estimate the value of FS improvement due to LCIG treatment, decreases in activities of daily living (ADL) limitations caused by LCIG treatment were calculated using data from a randomized, controlled, double-blind, double-dummy clinical trial and applied to the APD population in THEMIS.ResultsTotal burden of disability associated with APD was $17.7 billion (B). From clinical trial data, LCIG treatment versus SoC lowers the odds of difficulties in walking, dressing, and bathing by 76%, 42% and 39%, respectively. Among the APD population, these reductions generated $2.6B in value to patients and cost savings to payers. The added value was 15% of the burden of disability associated with APD and offsets 15% of the cost of LCIG treatment.ConclusionsFS improvements, consistent with improvements due to LCIG treatment, in the APD population created health benefits and reduced healthcare costs in the US.

Keywords: simulation; advanced Parkinson’s disease; functional status; activities of daily living; instrumental activities of daily living (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1515/fhep-2019-0021

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