OBJECTIVES: Parkinson’s disease (PD) is thought to be the fastest growing cause of neurologic disability in the US. We wanted to estimate its impact on healthcare resource utilization (HCRU) and costs.

METHODS: This retrospective, cross-sectional, matched case-control study was conducted using 2016 data from the 5% Medicare Limited Data Set. Patients ≥65 years with PD (cases) were identified if they had at least one inpatient or two outpatient claims for PD, were enrolled in the Medicare fee-for-service program, and had Part A and B coverage for all of 2016. Patients without PD (disease-free controls) were matched 1:1 to cases by age, gender, race, and geographic region (census regions: Northeast, South, Midwest, West). All-cause healthcare utilization and costs were compared between cases and controls. Descriptive results were reported.

RESULTS: A total of 14,689 matched case-control pairs were included in the study sample; mean (SD) age 78 (7.3) years, 42.7% female, 92.1% white with all regions represented (36.7% South, 26.7% Midwest, 20.1% Northeast and 16.4% West). Compared to controls, patients with PD had more outpatient office visits (mean [SD]:16 [15.0] vs. 12 [12.2]), and higher rates of home health (31.1% vs. 10.3%), hospice (4.4% vs. 0.9%), ED (39.4% vs. 23.3%), and inpatient (34.2% vs. 16.9%) use (all p>0.001). Mean (SD) annual all-cause Part A and Part B medical costs were statistically significantly higher in patients with PD than in controls ($94,780 [$220,636] vs. $50,489 [$194,980]) (p<0.001). The majority of costs were for non-ED outpatient services ($81,536 [$213,598] vs. $45,588 [$191,109]) and inpatient services ($12,221 [$25,858] vs. $4,406 [$14,736]) (p<0.001).

CONCLUSIONS: PD has dramatic effect on HCRU and costs. Based on our data, we estimate the excess annual Medicare expenditure on PD could exceed $40 billion. Therapies that prevent or slow the progression of PD may reduce HCRU and costs in affected populations.