OBJECTIVES: To prospectively evaluate the health economic burden of patients with Parkinson’s disease (PD) in Germany over a 12-months observation period. METHODS: Direct and indirect costs were evaluated in 145 patients with PD (mean age: 67.3±9.6 years) in Germany. Clinical evaluations were performed at baseline, 3, 6 and 12 months. Relevant economic data were documented in a special patient diary over the twelve-month period. Costs (2002€) were derived from various German medical economic resources. Costs were calculated from the perspective of health insurance (Gesetzliche Krankenkassse, GKV), transfer payment providers and the individual patient. Costs are presented as means±standard deviation (SD). RESULTS: We estimated per patient direct, indirect, and total costs for the 12-month period. The costs from the perspective of the health insurance GKV consist of direct medical costs 3770±7020€; including rehabilitation (1080±3320€), hospitalization (2200±5,590€), outpatient treatment (80 ± 50€), non-medical treatment (390±580€) and ambulatory diagnostic procedures (20±40€). In addition, drug costs for anti-parkinsonian treatment were 3350±2720€. Non-medical direct costs calculated from the GKV perspective were estimated to be 1040±3350€, which included transportation (30±50€), special equipment (880±3100€), social services (30±310€), and sickness benefit (110±1330€). The total medical (including drug costs) and non-medical direct costs for the GKV were 8160±8770€ and depends on disease severity and the occurrence of motor complications. For the nursing insurance payments of 2990±6590€ were calculated, for the retirement insurance 1,410±3,210€, and patient and caregiver costs of 3150±5320€. Total indirect costs amounted to 6,590±13,150€. On average, a total of 22,400±25,410€ per patient were attributable to PD. CONCLUSIONS: The result of the study clarifies the high financial burden of PD on society and patients. This underscores the need for further economic and medical research to optimize treatment for PD.