OBJECTIVE: To evaluate the different European health care structures involved in the care of Parkinson's disease (PD) as well as the economic impact of PD in European countries (EC). METHODS: Data are generated by desk top research (contacting national medical societies, PD specialists, institutes for statistics, third party payers, ministries, support groups and conducting structured database search). Reviewed data are: national treatment guidelines and treatment patterns, hospitalization, rehabilitation, disease management programs and availability of support groups. Epidemiologic data were elaborated by systematic literature review. RESULTS: 1) In France and the Czech Republic patients are mainly treated by neurologists, while in Sweden patients are preferably under care of General Practitioners. 2) Treatment guidelines are not standardized in Europe. 3) PD rehabilitation is differently organized in the EC, however, paucity of data precludes a detailed statement. United Kingdom (UK) PD society is developing a network of PD specialist nurses to co-ordinate multidisciplinary care, while in Germany and other EC no disease management programs exist. Total annual costs for PD differ: UK $280 million (Haycock, 1995), France $411 million (LePen, 1999), Sweden $136 million (Hagell, 2002) and Germany $1.0 billion (Dodel, 1998). Direct medical costs account for 20-40% of total costs depending on the Health care system, indirect costs account for approximately 22-50% of total costs in the UK (McMahon, 2000), Sweden (Hagell, 2002), and Germany (Spottke, 2002), respectively. Average length of stay differs among the EC (Germany 21.1d, UK 29.4d, France 19d and Italy 16.4d). CONCLUSION: PD care seems to be managed differently in the EC analyzed. Despite the importance of the disease detailed data are not easily accessible. One of the aims of EuroPa is to gather this information and optimize therapy for PD on an European level. These data are crucial for a cost effective and optimized therapy for PD patients.