Juvmo (tavapadon)

“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.” (opens the source at this quote in a new tab)CopyFlag

“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.” (opens the source at this quote in a new tab)CopyFlag

“The Medicare program bears the largest share of excess medical costs, as most PD patients are over age 65.” (opens the source at this quote in a new tab)CopyFlag

“Per PWP indirect and non-medical costs (PWP and care partner costs combined) were slightly higher than the per PWP direct medical cost ($25,558 vs. $24,439).” (opens the source at this quote in a new tab)CopyFlag

“For PWPs, the three largest indirect cost categories were future earnings loss due to PD-related premature death, earnings loss from reduced employment, and absenteeism.” (opens the source at this quote in a new tab)CopyFlag

“Projected PD prevalence will be more than 1.6 million with projected total economic burden surpassing $79 billion by 2037.” (opens the source at this quote in a new tab)CopyFlag

“We estimate that approximately 630,000 people in the United States had diagnosed PD in 2010, with diagnosed prevalence likely to double by 2040. The national economic burden of PD exceeds $14.4 billion in 2010 (approximately $22,800 per patient).” (opens the source at this quote in a new tab)CopyFlag

“The population with PD incurred medical expenses of approximately $14 billion in 2010, $8.1 billion higher ($12,800 per capita) than expected for a similar population without PD.” (opens the source at this quote in a new tab)CopyFlag

“We identified 27,394 cases and controls who were grouped into 3 survival groups. The mean age of the full study sample was 73 years.” (opens the source at this quote in a new tab)CopyFlag

“Based on the multivariable GLM, the 1-year incremental cost of PD was $9,625 (95% CI, $9,054-$10,197). The 3-year incremental cost of PD was $20,832 (95% CI, $19,390-$22,274). The 5-year incremental cost of PD was $27,466 (95% CI, 25,088-$29,844).” (opens the source at this quote in a new tab)CopyFlag

“The final sample (N = 144,703) had mean observed all-cause, primary PD-related, and any PD-related costs of $23,041 (SD, $34,045), $3429 (SD, $7431), and $9924 (SD, $22,140), respectively. Twenty percent of patients were classified as advanced PD.” (opens the source at this quote in a new tab)CopyFlag

“The incremental costs of advanced PD were $5818 (95% confidence interval [CI]: $5411–$6225) for all-cause costs, $3644 (95% CI: $3484–$3806) for primary PD-related costs, and $6088 (95% CI: $5779–$6398) for any PD-related costs (P < 0.001, all models).” (opens the source at this quote in a new tab)CopyFlag

“All costs were adjusted to 2018 U.S. dollars using the medical care component of the Consumer Price Index.” (opens the source at this quote in a new tab)CopyFlag

“Our data source was the 2013 Chronic Conditions Data Warehouse 100% Medicare dataset, which contains comprehensive claims for all patients with fee-for-service Medicare.” (opens the source at this quote in a new tab)CopyFlag

“Next, the algorithm searched chronologically for any consecutive 30-day period where the average LED was > 1000 mg/day. Patients with dosing satisfying this criterion were categorized as having advanced PD, regardless of whether they maintained dosing at that level throughout the year.” (opens the source at this quote in a new tab)CopyFlag

“Our LED > 1000 mg dosing threshold was based on the average medication dose observed in clinical trials of device-aided therapies, such as deep brain stimulation (DBS) and carbidopa-levodopa enteral suspension.” (opens the source at this quote in a new tab)CopyFlag

“Our final study sample included 144,703 Medicare beneficiaries with PD (Supporting Information Fig. S1). Twenty percent (n = 28,974) were categorized as having advanced PD via our medication-based algorithm; the remaining 80% were categorized as having mild/moderate PD (Table 1).” (opens the source at this quote in a new tab)CopyFlag

“Compared with the mild/moderate PD group, the advanced PD group had a greater percentage of individuals who were younger and male, who had a lower mean RxHCC risk score, and who had an outpatient neurologist visit during the year.” (opens the source at this quote in a new tab)CopyFlag

“Disease severity group comparisons on all patient variables were statistically significant at the P < 0.001 level.” (opens the source at this quote in a new tab)CopyFlag

“For instance, when examining any PD-related costs across patient deciles, mean costs were as low as $483 (SD, $166) in the lowest decile and as high as $48,145 (SD, $55,111) in the highest decile.” (opens the source at this quote in a new tab)CopyFlag

“More than half (57%) of the patients in the advanced PD group were in the four deciles with the highest costs (as compared with 35% of patients in the mild/moderate group), whereas more than half (54%) of the patients in the mild/moderate group were in the five deciles with the lowest costs (as compared with 30% of the advanced PD group).” (opens the source at this quote in a new tab)CopyFlag

“Further exploration of specific costs among the tenth (highest) decile compared with the next highest (ninth) decile revealed higher costs in every category we examined, with the biggest differences evident for inpatient and skilled nursing facility care (ie, inpatient costs $27,676 vs $2732 for the tenth vs ninth decile, respectively; skilled nursing care $9926 vs $408; Supporting Information Table S1).” (opens the source at this quote in a new tab)CopyFlag

“Among those in the mild/moderate group who incurred the highest (tenth decile) costs, 42% of those costs were related to inpatient services, 16% were due to home health care, and 13% were due to skilled nursing facility claims (Supporting Information Table S2).” (opens the source at this quote in a new tab)CopyFlag

“The pattern was even more pronounced for primary PD-related costs; the majority of patients in the advanced PD group (57%) were concentrated in the top three deciles (as compared with 23% of patients in the mild/moderate group; Fig. 2).” (opens the source at this quote in a new tab)CopyFlag

“The advanced PD group had mean unadjusted total all-cause costs ($24,988 [SD, $33,563]) that were approximately 10% higher than those of the mild/moderate group ($22,553 [SD, $34,147]), with the majority of the difference coming from higher pharmaceutical costs in the advanced PD group.” (opens the source at this quote in a new tab)CopyFlag

“In keeping with the fact that disease severity was assigned based on medication dose, mean primary PD-related pharmaceutical costs for the advanced PD group were more than triple those of the mild/moderate group ($3701 vs $1006, respectively) and represented a higher proportion of their overall primary PD-related costs (56% vs 38%; data not shown).” (opens the source at this quote in a new tab)CopyFlag

“One in three individuals in our mild/moderate PD group did not have a claim for a neurologist visit during our study year, nor did one in six individuals in our advanced PD group.” (opens the source at this quote in a new tab)CopyFlag

“Sensitivity analyses using alternate medication thresholds to define advanced PD (ie, levodopa dose > 1000 mg and LED > 800 mg) produced incremental costs of advanced PD that were smaller across all categories, although patterns were similar (Table 3).” (opens the source at this quote in a new tab)CopyFlag

“The medication-based algorithm we used to determine advanced disease status is newly developed and has not undergone full validation testing.” (opens the source at this quote in a new tab)CopyFlag

“In contrast, the nature of Medicare claims may have led us to overestimate the true costs of pharmaceutical treatment, because the Part D event files do not capture manufacturer rebates, remuneration (price concessions), and final adjustment for risk sharing.” (opens the source at this quote in a new tab)CopyFlag

“Although our study offers important insights into the health care cost burden of advanced PD within fee-for-service Medicare, our results did not include and may not generalize to patients covered by Medicare Advantage plans that offer coverage for Medicare Parts A, B, and D together, or to those with fee-for-service Medicare without a Part D prescription drug plan.” (opens the source at this quote in a new tab)CopyFlag

“Further, Medicare does not cover the considerable costs of treatment in long-term care facilities, which have been shown to represent a substantial proportion of overall costs to Medicare beneficiaries.” (opens the source at this quote in a new tab)CopyFlag

“Financial support for the study was provided by AbbVie.” (opens the source at this quote in a new tab)CopyFlag

“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.” (opens the source at this quote in a new tab)CopyFlag

“Of 1,309 patients, 41% experienced "OFF" episodes, 25% of whom were "OFF" ≥4 h/day.” (opens the source at this quote in a new tab)CopyFlag

“In the past 12 months, the number of hospitalizations, intensive care admissions, and emergency room visits; nights hospitalized; costs of consultations and hospitalizations; and total direct costs were all higher for patients experiencing "OFF" episodes (p < .05).” (opens the source at this quote in a new tab)CopyFlag

“Total average cost per patient-year was SEK 168,982 (EUR 15,958) and ranged from SEK 62,404 (EUR 5893) for H&Y stage I to SEK 1,056,324 (EUR 99,755) in H&Y stage V.” (opens the source at this quote in a new tab)CopyFlag

“The dominating part of total costs for early stages were indirect costs accounting for 50–60% while formal care made up for 55% and 81% of total costs in H&Y IV and V, respectively. Total mean costs for formal care, informal care, and productivity loss also increased with increasing off-time.” (opens the source at this quote in a new tab)CopyFlag

“The total mean cost per patient-year was SEK 168,982. Indirect costs accounted for 33% of total cost, formal care accounted for 30%, drugs for 13%, healthcare contacts for 12%, informal care for 11% and transports for less than 1%.” (opens the source at this quote in a new tab)CopyFlag

“Annual costs of healthcare contacts, drugs, formal and informal care, and productivity loss associated with PD were estimated using data from PARKreg linked with regional and national healthcare registers between 2013 and 2019.” (opens the source at this quote in a new tab)CopyFlag

“In total, 960 patients and 1324 observations (patient-years) were included.” (opens the source at this quote in a new tab)CopyFlag

“In this study, we defined H&Y I-II as early stage, III-IV as advanced stage and V as late stage.” (opens the source at this quote in a new tab)CopyFlag

“Most patient-years were found in H&Y I and II (68%), whereas 25% were in H&Y III, 6% in H&Y IV and 1% in H&Y V.” (opens the source at this quote in a new tab)CopyFlag

“The variable was presented in the following categories: 0%, 1-<25%, 25-<50%, and 50–100%.” (opens the source at this quote in a new tab)CopyFlag

“Costs are expressed in Swedish kronor (SEK), 2019 prices.” (opens the source at this quote in a new tab)CopyFlag

“A limitation of the study is that total costs for PD might be underestimated since only healthcare contacts registered with a PD diagnosis as main diagnosis were included.” (opens the source at this quote in a new tab)CopyFlag

“Even though the sample in this study covers all disease severity stages, it should be noted that the sample size in H&Y IV-V is relatively low compared to stages I-III, that is, 6% of all the patient-years are found in H&Y stage IV and only 1% in H&Y stage V.” (opens the source at this quote in a new tab)CopyFlag

“Moreover, off-time is a rough patient-reported estimate which may be affected by a recall bias.” (opens the source at this quote in a new tab)CopyFlag

“The research has received financial support from AbbVie, Medtronic, and Nordic Infucare (Air Liquide Healthcare).” (opens the source at this quote in a new tab)CopyFlag

“The percentage of patient-years with at least one stay increased from less than 1% in H&Y I to 14% in H&Y III, and 21% in H&Y V, whereas only 7% in H&Y IV had inpatient admissions.” (opens the source at this quote in a new tab)CopyFlag

“Overall mean drug cost was SEK 22,506. The mean costs in H&Y IV and V were considerable higher than for stages I and II.” (opens the source at this quote in a new tab)CopyFlag

“The mean (SD) cost for apomorphine infusion, LCIG, and LECIG was SEK 21,635 (85,168) for the 1-<25% off category compared to SEK 4053 (38,622) for the 0% (p < .001), SEK 17,756 (75,592) for the ≥25 to <50% (p < .01) and SEK 19,300 (84,127) for the ≥50% category (p < .01).” (opens the source at this quote in a new tab)CopyFlag

“Overall mean costs for formal care, including costs for nursing home, home help, personal assistance, home health care and electric wheelchair and scooter, were SEK 51,209. Home help and nursing home accounted for most of the costs, 50 and 30%, respectively.” (opens the source at this quote in a new tab)CopyFlag

“The use of informal care was considerably higher in H&Y IV than in the other stages, for 36% of the patient-years informal care of at least 1 h per week was reported and the mean number of hours per year was 634 h.” (opens the source at this quote in a new tab)CopyFlag

“In our study, the cost ranged from about a similar level in H&Y I, SEK 62,000, but to a considerably higher level in stage V, SEK 1 million mainly driven by costs for formal care and especially cost for nursing home (50% of the patient-years in H&Y V included costs for nursing home).” (opens the source at this quote in a new tab)CopyFlag

“We identified 469,055 individuals with PD who received Medicare benefits in 2002. Nearly 25% (more than 100,000 in total) resided in an LTCF.” (opens the source at this quote in a new tab)CopyFlag

“Hip fracture (AOR 2.10, 95% CI 2.04–2.15) and dementia (AOR 4.06, 95% CI 4.00–4.12) were the strongest clinical predictors of LTCF placement.” (opens the source at this quote in a new tab)CopyFlag

“Approximately, 50.3% with PDP + D reported ≥1 all-cause IP hospitalizations versus 36.0% with PDP (p < 0.05) during 12-month follow-up.” (opens the source at this quote in a new tab)CopyFlag

“Mean PPPY all-cause IP hospitalization costs for PDP + D patients versus PDP patients was $17,891 (±29,882) versus $11,599 (±$25,247) (p < 0.05).” (opens the source at this quote in a new tab)CopyFlag

“No differences in mean PPPY LT-stay costs were seen (Figure 2).” (opens the source at this quote in a new tab)CopyFlag

“In fact, PDP + D patients had 30%–40% higher rates of inpatient hospitalizations.” (opens the source at this quote in a new tab)CopyFlag

“Additionally, examination of hospitalization costs showed that PDP + D reported 54% greater mean PPPY IP hospitalization costs and two times greater mean PPPY SNF‐stay costs compared to patients with PDP.” (opens the source at this quote in a new tab)CopyFlag

“A total of 12,484 patients were eligible after our applying the study inclusion and exclusion criteria. Of these, 85.3% (n = 10,609) patients with PDP had a diagnosis for dementia in the post-PDP diagnosis period, while 14.7% (n = 1875) PDP patients did not have a diagnosis of dementia.” (opens the source at this quote in a new tab)CopyFlag

“Patients in both groups were matched using 1:1 propensity score matching (PSM) methodology using 31 variables (age, sex, race, region and 27 Elixhauser comorbidity characteristics).” (opens the source at this quote in a new tab)CopyFlag

“Patients were propensity score‐matched in a 1:1 ratio from the unmatched pool of PDP + D and PDP groups, yielding 1855 PDP + D and 1855 PDP patients.” (opens the source at this quote in a new tab)CopyFlag

“While other studies have posited that 80% of patients with PD progress to dementia in 2 decades, our analysis shows that approximately 85% of patients with PDP have incident dementia within a year after PDP diagnosis.” (opens the source at this quote in a new tab)CopyFlag

“Mean age (72 years), gender (50% males), race, and comorbidity profile were similar for both groups.” (opens the source at this quote in a new tab)CopyFlag

“Total cost for each claim, were calculated by adding the inpatient Medicare claim payment amount plus the claim pass through amount paid for the days stayed from the inpatient files.” (opens the source at this quote in a new tab)CopyFlag

“All cost amounts were inflated to 2019 dollars using the Medical Consumer Price Index (CPI) as reported by the US Bureau of Labor Statistics.” (opens the source at this quote in a new tab)CopyFlag

“Second, identification of psychosis was based on a diagnosis of psychosis-related hallucinations and delusions – so it is likely that PDP diagnosis is underestimated.” (opens the source at this quote in a new tab)CopyFlag

“Third, residual confounding may still exist, even though the study was adjusted for potential confounding issues through appropriate propensity score matching and covariate adjustment.” (opens the source at this quote in a new tab)CopyFlag

“Finally, it is important to acknowledge that diagnosis of dementia among patients with PDP may be difficult and, as such, result in underestimates of dementia diagnosis among these patients.” (opens the source at this quote in a new tab)CopyFlag

“This study was financially sponsored by Acadia Pharmaceuticals.” (opens the source at this quote in a new tab)CopyFlag

“Specifically, all-cause ST-stay, SNF-stay, and LT-stay among PDP + D versus PDP patients were: 45.2% versus 35.7%, 28.3% versus 15.7%, and 8.5% versus 6.0% (p < 0.05), respectively.” (opens the source at this quote in a new tab)CopyFlag

“Specifically, ST-stays stays were observed in” (opens the source at this quote in a new tab)CopyFlag

“45.2% of PDP + D patients and 33.6% of PDP patients (p < 0.05), while LT-stays were reported in 8.6% of PDP + D patients compared to 6.0% of PDP patients (p < 0.05). SNF-stays were also higher among PDP + D patients (28.4% vs. 15.6%; p < 0.05) compared to those with PDP.” (opens the source at this quote in a new tab)CopyFlag

“In all groups, health care service utilization increased over the last year of life, and total costs were predominantly attributable to inpatient care. In the last 6 months of life, neurologist care was infrequent among patients with neurodegenerative disease (AD: 1.5%; PD: 8.6%; ALS: 32.0%).” (opens the source at this quote in a new tab)CopyFlag

“In the last 6 months of life (Table 2), ED utilization rates were greatest among decedents with pancreatic cancer (n = 8,009, 43.1%) and malignant brain tumors (n = 2,835, 42.8%), followed by decedents with PD (n = 20,400, 38.8%), ALS (n = 1,409, 36.2%), and AD (n = 97,022, 35.1%).” (opens the source at this quote in a new tab)CopyFlag