Patient Utilities in Parkinson's Disease in Health States Based on Hoehn and Yahr and Off-Time


Norlin J1, Kellerborg K1, Odin P2
1The Swedish Institute for Health Economics, Lund, Sweden, 2Lunds Universitet, Lund, Sweden

OBJECTIVES : Parkinson’s disease is a progressive neurologic disease, with a major impact on patients’ daily living and Quality of Life. Currently available levodopa-therapies mainly target motor-symptoms. Cost-effectiveness models are generally based on health states defined by Hoehn & Yahr, which reflects the progression of disease, and the proportion of awake time in “off”, which reflects the time periods of the day when there is poor or no response to treatment. The objective was twofold; Firstly, to estimate patient utilities in health states based on Hoehn & Yahr and off-time. Secondly, to explore the correlation between the EQ-5D dimensions and the Hoehn & Yahr and off-time.

METHODS : Patients with idiopathic Parkinson’s disease in the National Parkinson’s Disease Patient Registry (PARKreg) in Sweden with registrations of EQ-5D-3L, Hoehn & Yahr and off-time were included in the study. The relationship between the EQ-5D-3L and Hoehn & Yahr and off-time were estimated by multiple linear regression. Patient utilities were estimated for 24 health states, based on Hoehn & Yahr and off-time. Correlations were analyzed with Spearman’s correlations test.

RESULTS : In total, 1041 patients were included in analyses. The predicted utilities for health states ranged from -0.05 to 0.93. Dimensions 'Self-care', 'Mobility' and 'Usual activities' correlated moderately with Hoehn & Yahr (rs = 0.48, rs = 0.46, rs = 0.45 respectively), whereas weak correlations were found for 'Anxiety/Depression' and 'Pain/Discomfort' (rs = 0.27, rs = 0.22 respectively). All dimensions correlated weakly with off-time.

CONCLUSIONS : As expected, the utility deteriorated with increasing severity in Hoehn & Yahr and off-time. The correlations between the EQ-5D dimensions reflecting non-motor symptoms and the Hoehn & Yahr and off-time were weak. Future cost-effectiveness analyses, in particular of novel disease modifying drugs, should consider capturing other measures of disease severity, to also reflect non-motor symptoms.

Conference/Value in Health Info

2021-05, ISPOR 2021, Montreal, Canada

Value in Health, Volume 24, Issue 5, S1 (May 2021)




Patient-Centered Research

Topic Subcategory

Health State Utilities


Neurological Disorders

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