Budget Impact analysis of a new system of care in Parkinson's disease patients

Objective: To estimate the economic impact of the introduction of a new care system based on apomorphine and Patient Support Program for motor fluctuations ("on-off" phenomena) in patients with Parkinson's disease which are not sufficiently controlled by oral anti-Parkinson medication in Italy.Method: A Budget Impact model was developed to evaluate the new care system in patients with Parkinson's disease over a 3-years' time horizon. The comparator treatments included in the analysis were treatments based on apomorphine and levodopa + carbidopa. The analysis was conducted from a National Health Service (NHS) perspective. Costs included in the analysis were acquisition costs and device costs. A deterministic sensitivity analysis was carried out to evaluate the uncertainty of the parameters used. A break-even analysis was conducted to identify the minimum number of subjects that would need to be treated with the new care system to obtain a positive Budget Impact (World With - World Without = 0).Results: The analysis shows that the introduction of the new care system based on apomorphine could generate a cost saving incurred by the NHS of over euro 5.7 million in 3 years. Break-even analysis shows that if it were pos-sible to intercept with the new treatment at least 9 patients treated with apomorphine, there would not be an increase in costs for the NHS.Conclusion: The new care system would respond to the unmet needs of patients with Parkinson's disease by generating a reduction in the expenditure incurred by NHS.