Limitations of Current Evaluation Techniques for the Cost-Effectiveness of Treatments for Parkinson’s Disease

Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. Pharmaceutical and surgical therapies for PD are available and can alleviate the symptoms and complications. Unfortunately, despite these therapies, the disease relentlessly progresses. A new study in the journal Value in Health presents a detailed overview of the current decision-analytic models used to evaluate the cost-effectiveness of therapeutic options in Parkinson’s disease.

Lead author Uwe Siebert notes “this article gives an insight into the different methodological approaches used to estimate the cost-effectiveness of treatments for a chronic progressive disorder. Cost-effectiveness is an important issue in PD as newer therapeutic options are costly.” Corresponding author Richard Dodel stresses, “Although each of these studies has its distinct value, most currently available models do not explicitly capture the large spectrum of clinically relevant symptoms that physicians must consider in daily clinical decision making.”

This study aims to provide decision analysts and clinicians interested in formal medical decision making with an insight into the structural and methodological approaches used in PD decision modeling, including their strengths and limitations. Studying the long-term effect of treatment on clinical symptoms and health-related quality of life is important in evaluating PD interventions. However, since most clinical trials are short, mathematical models must be used to link the short-term clinical outcomes from clinical trials with evidence for the long-term progression of the disease. PD is particularly complex because of the wide spectrum of PD symptoms and treatment complications, and the lifelong progression of the disease. The authors conclude that decision-analytic modeling is a useful tool in clinical decision-making and the economic evaluation of interventions in PD. It cannot replace clinical studies but rather complements them to better inform physicians and policy makers about the potential long-term effectiveness and costs of new and promising interventions.