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Advancing the scope of costs and benefits

Dates: 2011-2013
Funding: Parkinson's UK
Information: Emma McIntosh

In recent years there have been huge advances in economic methodology to assist decision makers in the allocation of our scarce health care resources. These methodological advances take the form of statistical and economic developments. While many disease areas such as cancer and diabetes have benefited from such advances, Parkinson's, with its complex nature and associated impacts on carers has received little attention from health economists. The aim of this project is to use up to date economic methodology to clearly identify the costs and benefits associated with Parkinson's Disease interventions and health states more generally.

It is evident from the available literature that the economics of Parkinson’s is currently under researched. Whilst a number of economics publications have contributed to the evidence base in this area independently on costs and health care outcomes, significant gaps remain on the cost-effectiveness of strategies in this area. At present Government funding for many health care procedures is often based on inaccurate cost data, due to the complexity of costing disease treatment pathways. Parkinson’s is no exception to this. It is therefore important to have robust evidence on both the short and long term costs and health care outcomes of Parkinson's interventions. Such information allows decision makers to prioritise such funding appropriately using robust evidence. The economics of Parkinson’s not only relates independently to costs and health care outcomes but the combination of these elements taking into consideration both patients and carers.

The aim of this research is to improve the evidence base for the costs, benefits and cost-effectiveness of interventions and therapies for the treatment of PD. In doing so the costs and benefits of any new research can be directly incorporated into an appropriate economic evaluation framework. Such a framework is crucial for decision making bodies in health care such as the National Institute for Health and Clinical Excellence (NICE) to correctly interpret the costs, benefits and cost-effectiveness of interventions and therapies arising from new and existing research in PD. Further to this, broader aspects of Parkinson’s patients 'capabilities' which go beyond traditional health care outcomes are highly important from an economic perspective as they constitute important ‘outcomes’. Such outcomes are often omitted within Parkinson’s evaluative studies. This is partly due to lack of suitable measures for this purpose, hence where interventions or therapies are indeed able to improve such capabilities the appropriate recognition is not being given. Such important effects on health and wellbeing are thus being underrepresented and hence impacts upon them are not being considered accordingly within funding decisions. Further to this the true experience of Parkinson’s patients carers and the impact on their quality of life and capabilities more broadly is an under researched topic. A recent article showed that care provided by carers accounts for 80% of annual service costs. This highlights further that key economic evidence available to decision makers for Parkinson’s is limited. The available evidence is therefore unlikely to be representing the full impact of the disease when it comes to allocation of resources for this group of patients and their carers. Hence, there is a need for targeted research into the economics of Parkinson’s using up to date, novel economic methodology exploring the costs and benefits of Parkinson’s health states and the cost-benefit of Parkinson’s treatments more broadly incorporating the full impact on carers (in terms of both costs and benefits).

This research has two distinct themes of work. Theme 1 will  use pre-existing data from two of the largest ever trials in Parkinson’s. Theme 2 will use survey methods to carry out new empirical research to evaluate Parkinson’s patients preferences for health states or states of ‘well being’.

Parkinson's UK website