Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients

C. Lundqvist, A. G. Beiske, O. Reiertsen, Ivar Sønbø Kristiansen

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life year (QALY) were estimated for conventional treatment prior to switch and for 1-year treatment with IDL. Probabilistic sensitivity analysis was based on bootstrapping. IDL significantly improved functional scores and was safe to use. One-year conventional oral treatment entailed 0.63 QALY while IDL entailed 0.68 (p > 0.05). The estimated total 1-year treatment cost was NOK419,160 on conventional treatment and NOK890,920 on IDL, representing a cost of NOK9.2 million (a,not sign1.18 mill) per additional QALY. The incremental cost per unit UPDRS improvement was NOK25,000 (a,not sign3,250). Medication was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.
    OriginalsprogEngelsk
    TidsskriftJournal of Neurology
    Vol/bind261
    Udgave nummer12
    Sider (fra-til)2438-2445
    ISSN0340-5354
    DOI
    StatusUdgivet - 2014

    Citer dette

    Lundqvist, C. ; Beiske, A. G. ; Reiertsen, O. ; Sønbø Kristiansen, Ivar . / Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients. I: Journal of Neurology. 2014 ; Bind 261, Nr. 12. s. 2438-2445.
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    abstract = "Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life year (QALY) were estimated for conventional treatment prior to switch and for 1-year treatment with IDL. Probabilistic sensitivity analysis was based on bootstrapping. IDL significantly improved functional scores and was safe to use. One-year conventional oral treatment entailed 0.63 QALY while IDL entailed 0.68 (p > 0.05). The estimated total 1-year treatment cost was NOK419,160 on conventional treatment and NOK890,920 on IDL, representing a cost of NOK9.2 million (a,not sign1.18 mill) per additional QALY. The incremental cost per unit UPDRS improvement was NOK25,000 (a,not sign3,250). Medication was the dominant cost during IDL (45 {\%} of total costs), it represented only 6.4 {\%} of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.",
    author = "C. Lundqvist and Beiske, {A. G.} and O. Reiertsen and {S{\o}nb{\o} Kristiansen}, Ivar",
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    Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients. / Lundqvist, C.; Beiske, A. G.; Reiertsen, O.; Sønbø Kristiansen, Ivar .

    I: Journal of Neurology, Bind 261, Nr. 12, 2014, s. 2438-2445.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients

    AU - Lundqvist, C.

    AU - Beiske, A. G.

    AU - Reiertsen, O.

    AU - Sønbø Kristiansen, Ivar

    PY - 2014

    Y1 - 2014

    N2 - Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life year (QALY) were estimated for conventional treatment prior to switch and for 1-year treatment with IDL. Probabilistic sensitivity analysis was based on bootstrapping. IDL significantly improved functional scores and was safe to use. One-year conventional oral treatment entailed 0.63 QALY while IDL entailed 0.68 (p > 0.05). The estimated total 1-year treatment cost was NOK419,160 on conventional treatment and NOK890,920 on IDL, representing a cost of NOK9.2 million (a,not sign1.18 mill) per additional QALY. The incremental cost per unit UPDRS improvement was NOK25,000 (a,not sign3,250). Medication was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.

    AB - Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life year (QALY) were estimated for conventional treatment prior to switch and for 1-year treatment with IDL. Probabilistic sensitivity analysis was based on bootstrapping. IDL significantly improved functional scores and was safe to use. One-year conventional oral treatment entailed 0.63 QALY while IDL entailed 0.68 (p > 0.05). The estimated total 1-year treatment cost was NOK419,160 on conventional treatment and NOK890,920 on IDL, representing a cost of NOK9.2 million (a,not sign1.18 mill) per additional QALY. The incremental cost per unit UPDRS improvement was NOK25,000 (a,not sign3,250). Medication was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.

    U2 - 10.1007/s00415-014-7515-4

    DO - 10.1007/s00415-014-7515-4

    M3 - Journal article

    VL - 261

    SP - 2438

    EP - 2445

    JO - Journal of Neurology

    JF - Journal of Neurology

    SN - 0340-5354

    IS - 12

    ER -