Direct cost of Parkinson's disease in a health system with high judicialization: evidence from Colombia

Expert Rev Pharmacoecon Outcomes Res. 2020 Dec;20(6):587-593. doi: 10.1080/14737167.2020.1681266. Epub 2019 Oct 18.

Abstract

Objective: To estimate all-claims-all-conditions expenditures paid for by health plans for patients suffering from Parkinson´s disease (PD). Methods: Using administrative claims data from two health maintenance organizations for 2014 and 2015 in Colombia, we identified 2,917 patients with PD by applying an algorithm that uses International Statistical Classification of Diseases and Related Health Problems and Anatomical Therapeutic Chemical Classification System codes. Descriptive statistics were applied to compute unadjusted all-cause median costs. A generalized linear model was used to estimate adjusted and attributable direct costs of advanced PD. Results: Approximately 30% of the all-cause direct costs were associated with technologies not included in universal health coverage benefit packages. In 2015, the annual median interquartile range per patient all-cause direct costs to insurers was USD1,576 (605-3,617). About 16% of patients had advanced PD. Regression analysis estimated that additional costs attributable to advanced PD was USD3,416 (p = 0.000). Multimorbidity was highly prevalent, and 96% of PD patients had at least one other chronic condition. Conclusions: In the context of high judicialization, patients suffering from PD must increasingly use the judicial system to access treatment. To promote more equitable and efficient access benefit packages, developing countries must consider more thoroughly the needs of these patients.

Keywords: Parkinson’s disease; cost analysis; cost of illness; health economics; judicialization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colombia
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Expenditures / statistics & numerical data
  • Health Maintenance Organizations / economics*
  • Health Maintenance Organizations / statistics & numerical data
  • Humans
  • Insurance, Health / economics
  • Insurance, Health / standards
  • Male
  • Middle Aged
  • Parkinson Disease / economics*
  • Parkinson Disease / therapy