Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries

Christopher Kruse, Anna Lipinski, Malte Verheyen, Monika Balzer-Geldsetzer, Michael Wittenberg, Stefan Lorenzl, Carmen Richinger, Christian Schmotz, Lars Tönges, Dirk Woitalla, Stephan Klebe, Bastiaan R. Bloem, Adrianus Hommel, Wassilios G. Meissner, Brice Laurens, Thomas Boraud, Alexandra Foubert-Samier, Sylvain Vergnet, François Tison, Nadège CostaPer Odin, Kristina Rosqvist, Jenny M. Norlin, Frida Hjalte, Anette Schrag, Richard Dodel

Research output: Contribution to journalArticlepeer-review


Background: Parkinson's disease (PD) is a neurodegenerative disease that leads to progressive disability. Cost studies have mainly explored the early stages of the disease, whereas late-stage patients are underrepresented. Objective: The aim is to evaluate the resource utilization and costs of PD management in people with late-stage disease. Methods: The Care of Late-Stage Parkinsonism (CLaSP) study collected economic data from patients with late-stage PD and their caregivers in five European countries (France, Germany, the Netherlands, UK, Sweden) in a range of different settings. Patients were eligible to be included if they were in Hoehn and Yahr stage >3 in the on state or Schwab and England stage at 50% or less. In total, 592 patients met the inclusion criteria and provided information on their resource utilization. Costs were calculated from a societal perspective for a 3-month period. A least absolute shrinkage and selection operator approach was utilized to identify the most influential independent variables for explaining and predicting costs. Results: During the 3-month period, the costs were €20,573 (France), €19,959 (Germany), €18,319 (the Netherlands), €25,649 (Sweden), and €12,156 (UK). The main contributors across sites were formal care, hospitalization, and informal care. Gender, age, duration of the disease, Unified Parkinson's Disease Rating Scale 2, the EQ-5D-3L, and the Schwab and England Scale were identified as predictors of costs. Conclusion: Costs in this cohort of individuals with late-stage PD were substantially higher compared to previously published data on individuals living in earlier stages of the disease. Resource utilization in the individual sites differed in part considerably among these three parameters mentioned.

Original languageEnglish
Pages (from-to)571-584
Number of pages14
JournalMovement Disorders
Issue number3
Publication statusPublished - 2024 Mar

Subject classification (UKÄ)

  • Neurology

Free keywords

  • cost-of-illness
  • late-stage parkinsonism
  • Parkinson's disease
  • resource utilization


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