PND133 IMPACT OF CLINICAL COMPLICATIONS ON ECONOMIC BURDEN IN NEWLY DIAGNOSED PARKINSON POPULATION USING A US CLAIM DATABASE

Abstract

To assess the clinical complications in newly diagnosed population and its impact on economic burden in US claim database. Parkinson disease (PD) Patients were identified from a US, health insurance claims database, Optum Clinformatics, between January 2010 and October 2014. PD was defined as >1 ICD-9 code 332.xx (excluding 332.1) or >1 ICD-10 code G20. Patients with pharmacy claims of PD medications [dopamine replacement, catechol-O-methyltransferase inhibitors, dopamine agonists, monoamine oxidase B inhibitors or amantadine] taken during treatment initiation period were considered as treated the others were defined as not treated. Clinical burden was assessed through the incident occurrence of 4 different classes of motor and non-motors complications over the 1-Year follow-up period. During this period economic burden was also calculated overall and by types of costs (inpatient, emergency room, outpatient and pharmaceutical). 4,476 patients were included with a mean age 74.5 years, 57% were female, 53.5% were not treated in the year after diagnosis. The most frequent 1-year incident complications in global population were falls and injuries (22.2% of patients), neuropsychiatric disorders (20.9%), autonomic dysfunction (18.9%), and sleep disorders (10.6%). These complications appeared highest in treated cohort versus not treated patients. Total all-causes costs were $30,875, mainly inpatient costs ($19,897). PD-related costs were $29,373. Annual costs was significantly driven by age, baseline chronic comorbidities and 3 incident complications (neuropsychiatric disorders, falls and injuries and autonomic dysfunction) which showed around +$15,000 of incremental costs respectively. Analyses from a large scale national medical claims database highlight an important clinical burden for PD newly diagnosed patients even for those having initiated levodopa equivalent treatments. These complications appeared to be a strong driver for economic burden. Despite intake of PD treatment, these results show also an increase of clinical outcomes associated with the disease progression and then increase costs.