PMID- 37551376
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230809
IS  - 1178-6981 (Print)
IS  - 1178-6981 (Electronic)
IS  - 1178-6981 (Linking)
VI  - 15
DP  - 2023
TI  - Treatment Patterns and Healthcare Resource Use in Medicare Beneficiaries with 
      Parkinson's Disease.
PG  - 631-643
LID - 10.2147/CEOR.S422023 [doi]
AB  - BACKGROUND: Studies on real-world treatment patterns and long-term economic 
      burden of Parkinson's disease (PD) have been limited. OBJECTIVE: To assess 
      treatment patterns, healthcare resource utilization (HRU), and costs associated 
      with PD symptoms and treatment-related adverse events (AEs) among Medicare 
      beneficiaries in the United States. METHODS: A 100% Medicare Fee-For-Service data 
      (2006-2020) of patients with PD were analyzed. PD treatment patterns were 
      described for the subset of patients who had no previously observed PD treatments 
      or diagnoses (ie, the incident cohort). HRU and healthcare costs associated with 
      PD symptoms were assessed for all patients with PD (ie, the overall cohort) and 
      that associated with treatment-related AEs were assessed for the subset of 
      patients who received PD treatments after PD diagnosis (ie, the active treatment 
      cohort), using longitudinal models with repeated measures. RESULTS: Overall, 
      318,582 patients were included (mean age at PD diagnosis: 77.4 years; 53.3% 
      female). Among patients in the incident cohort (N=214,829), 51.1% initiated 
      levodopa monotherapy and 5.9% initiated dopamine agonists (DAs) monotherapy as 
      first-line treatment. The proportion of incident patients treated with DAs and 
      other PD therapies generally increased from post-diagnosis years 1 to 10. The 
      median time from diagnosis to PD treatment initiation was 2.0 months; the median 
      time to treatment discontinuation was the longest with levodopa (18.7 months), 
      followed by DAs (9.5 months). In the overall cohort, PD symptoms, especially 
      motor symptoms and severe motor symptoms, were associated with significantly 
      higher rates of HRU and costs. In the active treatment cohort (N=234,298), 
      treatment-related AEs were associated with significantly higher rates of HRU and 
      medical costs. CONCLUSION: While levodopa is still the mainstay of PD management, 
      considerable heterogeneity exists in real-world treatment patterns. Overall, PD 
      symptoms and AEs were associated with significantly higher HRU and healthcare 
      costs, suggesting unmet medical needs for PD treatments with better tolerability 
      profiles.
CI  - (c) 2023 Song et al.
FAU - Song, Yan
AU  - Song Y
AUID- ORCID: 0000-0002-7566-2813
AD  - Analysis Group, Inc, Boston, MA, USA.
FAU - E, Jian-Yu
AU  - E JY
AD  - Analysis Group, Inc, Boston, MA, USA.
FAU - Guo, Tracy
AU  - Guo T
AD  - Analysis Group, Inc, Boston, MA, USA.
FAU - Sasane, Rahul
AU  - Sasane R
AD  - Cerevel Therapeutics, Cambridge, MA, USA.
FAU - Arcona, Steve
AU  - Arcona S
AUID- ORCID: 0000-0001-7926-5420
AD  - Cerevel Therapeutics, Cambridge, MA, USA.
FAU - Keshava, Nirmal
AU  - Keshava N
AD  - Cerevel Therapeutics, Cambridge, MA, USA.
FAU - Wu, Eric
AU  - Wu E
AD  - Analysis Group, Inc, Boston, MA, USA.
LA  - eng
PT  - Journal Article
DEP - 20230802
PL  - New Zealand
TA  - Clinicoecon Outcomes Res
JT  - ClinicoEconomics and outcomes research : CEOR
JID - 101560564
PMC - PMC10404422
OTO - NOTNLM
OT  - Parkinson's disease
OT  - adverse events
OT  - healthcare costs
OT  - healthcare resource utilization
OT  - treatment patterns
COIS- Yan Song, Tracy Guo, and Eric Wu are employees of Analysis Group, Inc., and 
      Jian-Yu E is a former employee of Analysis Group, Inc., a consulting company that 
      has provided paid consulting services to Cerevel Therapeutics, which funded the 
      development and conduct of this study and manuscript. Rahul Sasane, Steve Arcona, 
      and Nirmal Keshava are employees of Cerevel Therapeutics and may own stock and/or 
      stock options of the company. The authors report no other conflicts of interest 
      in this work.
EDAT- 2023/08/08 06:42
MHDA- 2023/08/08 06:43
PMCR- 2023/08/02
CRDT- 2023/08/08 03:36
PHST- 2023/05/19 00:00 [received]
PHST- 2023/07/25 00:00 [accepted]
PHST- 2023/08/08 06:43 [medline]
PHST- 2023/08/08 06:42 [pubmed]
PHST- 2023/08/08 03:36 [entrez]
PHST- 2023/08/02 00:00 [pmc-release]
AID - 422023 [pii]
AID - 10.2147/CEOR.S422023 [doi]
PST - epublish
SO  - Clinicoecon Outcomes Res. 2023 Aug 2;15:631-643. doi: 10.2147/CEOR.S422023. 
      eCollection 2023.