Probabilistic cost-effectiveness analysis for early detection of Parkinson's disease
Date Issued
2011
Date
2011
Author(s)
Hsiao, Chih-Wen
Abstract
Background: Parkinson''s disease (PD) is the second most common neurodegenerative disease in Taiwan. A total of 85,510 patients suffered from PD have been under treated in 2008 in Taiwan. It has been showed that screening for early PD can lead to 51% reduction for late stage of PD, and 25% mortality reduction. Thus, early detection could relieve medical burden from PD for patients themselves, the family members, and even for society. However, the cost-effectiveness of PD screening was never addressed. The aim of this thesis was to evaluate the cost-effectiveness of PD screening program.
Materials and Methods: Parameters used in the Markov decision analytic model considering disease progress and the efficacy of PD screening were derived from Keelung Community–based survey for PD in 2001, which targeted at residents aged 40 years and above. Data on cost of PD treatment was derived from the national health insurance claimed data during the period of 2001 to 2008. Both deterministic and probabilistic cost-effectiveness analyses of PD screening program were conducted with computer simulation for a simulated hypothetical cohort of residents aged 40 years and above. The health policy maker’s view point was used for economic analysis.
Results: Without considering discount rate, compared with no screen strategy, the incremental cost-effectiveness ratios (ICER) of PD screening with one-shot or with different interscreening intervals ranged from NTD 16,447 to 59,577 per life-year gained. The ICERs ranged from NTD 23,167 to 76,125 per life year gained considering 3% discount rate. The best strategy is one-shot screen for ceiling ratio ranged from NTD 21,000 to 80,000. The second and third strategies were triennial screen and biennial screen for which the ceiling ratios changed from NTD 80,000 to 110,000, and NTD 10,000 to 255,000, respectively. If the ceiling ratio is larger than NTD 255,000, then annual screen became the most cost-effective strategy.
Conclusion: PD screening program is cost-effective.
Subjects
Parkinson's disease
early detection
community-based Parkinson's disease screeening
probabilistic cost-effectiveness analysis
SDGs
Type
thesis
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