Average annual cost of Parkinson’s disease in São Paulo, Brazil, with a focus on disease-related motor symptoms

Tânia M Bovolenta,1 Sônia Maria Cesar de Azevedo Silva,2 Roberta Arb Saba,3 Vanderci Borges,2 Henrique Ballalai Ferraz,2 Andre C Felicio1 1Hospital Israelita Albert Einstein, São Paulo, 2Neurology Department, Federal University of São Paulo, UNIFESP, São Paulo, 3Neurology Department, Federal University of São Paulo, UNIFESP, São Paulo, Brazil Background: Although Parkinson’s disease is the second most prevalent neurodegenerative disease worldwide, its cost in Brazil – South America’s largest country – is unknown.Objective: The goal of this study was to calculate the average annual cost of Parkinson’s disease in the city of São Paulo (Brazil), with a focus on disease-related motor symptoms.Subjects and methods: This was a retrospective, cross-sectional analysis using a bottom-up approach (ie, from the society’s perspective). Patients (N=260) at two tertiary public health centers, who were residents of the São Paulo metropolitan area, completed standardized questionnaires regarding their disease-related expenses. We used simple and multiple generalized linear models to assess the correlations between total cost and patient-related, as well as disease-related variables.Results: The total average annual cost of Parkinson’s disease was estimated at US$5,853.50 per person, including US$3,172.00 in direct costs (medical and nonmedical) and US$2,681.50 in indirect costs. Costs were directly correlated with disease severity (including the degree of motor symptoms), patients’ age, and time since disease onset.Conclusion: In this study, we determined the cost of Parkinson’s disease in Brazil and observed that disease-related motor symptoms are a significant component of the costs incurred on the public health system, patients, and society in general. Keywords: Parkinson’s disease, health economics, cost of illness, health evaluation, cost analysis