Quality of Life and Costs in Parkinson's Disease: A Cross Sectional Study in Hungary

BACKGROUND Patient reported outcomes and costs of illness are useful to capture some of the multiple effects of a disease and its treatments. Our aim was to assess quality of life (QoL) and costs of Parkinson's disease (PD) in Hungary, and to analyze their associations. METHODS A cross-sectional questionnaire survey was conducted in one neurology university clinic. Clinical characteristics, PD related resource utilizations and productivity loss in the past 12 months were recorded; the Hoehn&Yahr (HY) scale, PDQ-39 and EQ-5D questionnaires were applied. Cost calculation was performed from the societal perspective. RESULTS 110 patients (34.5% female) were involved with mean age of 63.3 (SD=11.3) and disease duration of 8.2 (SD=5.8) years. PDQ-39 summary score was 48.1 (SD=13.4). The average EQ-5D score was 0.59 (SD=0.28), and was significantly lower than the population norm in age-groups 45-74. The correlation was significant between EQ-5D and PDQ-39 (-0.47, p=0.000), the HY scale and EQ-5D (-0.3416, p=0.0008) and PDQ-39 (0.3419, p=0.0006) scores. The total mean cost was €6030.2 (SD=6163.0)/patient/year (direct medical 35.7%, direct non-medical 29.4%, indirect cost 34.9%). A one year increase in disease duration and 0.1 decrease of the EQ-5D utility score increase the yearly costs by 8 to 10%, and 7.8%, respectively. The effect of the PDQ-39 score on total cost was not significant. CONCLUSIONS Disease severity and public health importance of PD are clearly demonstrated by the magnitude of QoL loss. PD-related costs are substantial, but are much lower in Hungary than in Western European countries. Disease duration and EQ-5D score are significant proxy of costs.