Abstract

Background:

Interest in non-pharmacological/non-surgical interventions to treat Parkinson’s disease (PD) has substantially increased. Although a few health-economic studies have been conducted, summary information on the cost-effectiveness is still scarce.

Objective:

To give an overview of cost-effectiveness analyses (CEA) focusing on non-pharmacological/non-surgical interventions in PD patients.

Methods:

A systematic literature search was conducted in five databases. Studies were included that provided cost-effectiveness analysis (CEA) or cost-utility analysis (CUA) of non-pharmacological/non-surgical interventions in PD patients. Study quality was assessed with the Drummond and CHEERS 2022 checklists respectively, for economic evaluation.

Results:

N = 9 studies published between 2012–2023 were identified. Most studies undertook a CUA (n = 5); n = 3 reported a combination of CEA and CUA, and n = 1 a pure CEA. Most studies (n = 6) examined physical exercise. The CEA studies identified additional costs of 170€ –660€ for the improvement of one single unit of a clinical outcome and savings of 18.40€ –22.80€ per score gained as measured with established instruments. The four studies that found significant quality of life benefits show large variations in the incremental cost effectiveness ratio (ICER) of 3,220€ –214,226€ per quality-adjusted life year (QALY); notably interventions were heterogenous regarding content and intensity.

Conclusions:

Despite increasing numbers of non-pharmacological/non-surgical intervention trials in PD patients, health-economic evaluations are rare. The examined intervention types and health-economic results vary greatly. Together with the heterogeneity of the health-economic studies these factors limit the conclusions that can be drawn. Further research and a standardization of methods is needed to allow decision makers to make meaningful interpretations, and to allocate scarce resources.

中文翻译：

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特发性帕金森病非药物和非手术干预措施的成本效益分析：系统评价

摘要

背景：

人们对非药物/非手术干预治疗帕金森病 (PD) 的兴趣大幅增加。尽管已经进行了一些健康经济学研究，但有关成本效益的摘要信息仍然很少。

客观的：

概述重点关注 PD 患者非药物/非手术干预的成本效益分析 (CEA)。

方法：

在五个数据库中进行了系统的文献检索。纳入的研究提供了 PD 患者非药物/非手术干预的成本效益分析 (CEA) 或成本效用分析 (CUA)。研究质量分别使用 Drummond 和 CHEERS 2022 检查表进行评估，以进行经济评估。

结果：

 确定了 2012 年至 2023 年期间发表的N = 9 项研究。大多数研究进行了 CUA（n  = 5）；n  = 3 报告了 CEA 和 CUA 的组合，n  = 1 报告了纯 CEA。大多数研究（n  = 6）检查体育锻炼。CEA 研究发现，改善一个单位的临床结果需要额外花费 170 欧元至 660 欧元，并且使用现有仪器测量得到的每个分数可节省 18.40 欧元至 22.80 欧元。发现生活质量显着获益的四项研究表明，增量成本效益比 (ICER) 存在巨大差异，每个质量调整生命年 (QALY) 为 3,220 欧元 - 214,226 欧元；值得注意的是，干预措施在内容和强度方面存在差异。

结论：

尽管针对帕金森病患者的非药物/非手术干预试验数量不断增加，但健康经济学评估却很少。所检查的干预类型和健康经济结果差异很大。加上健康经济研究的异质性，这些因素限制了可以得出的结论。需要进一步的研究和方法标准化，以使决策者能够做出有意义的解释，并分配稀缺资源。