Objective: To determine the potential cost savings and quality of life gains with the Personal KinetiGraph (PKG) in the management of patients with Parkinson’s disease in Australia.

Background: The Personal KinetiGraph (PKG) is a wrist-worn medical device that collects a patient’s movement data using a digital accelerometer. The information provided by the PKG allows clinicians to optimise therapy on the basis of an objective home evaluation. A pilot RCT (Kotschet et al.) measured the impact of PKG (assessed by a movement disorder specialist (MDS) compared to a MDS (without the use of PKG) in reducing suboptimal treatment, in a population of PD patients considered to be well-controlled at the time of recruitment.

Methods: An economic model was built to compare PKG plus MDS to MDS alone in the management of Parkinson’s disease. The economic model translated a reduction in UPDRS-III to an improvement in Quality of Life (QoL), and a reduction in resource utilisation costs. Costs and outcomes were assessed over a model horizon of one year. Sensitivity analyses were performed for the following parameters: Number of PKG courses per patient per year, PKG incremental benefit (measured by UPDRS-III), utility gain per UPDRS point improvement, and resource utilisation cost saving per UPDRS-III point improvement.

Results: The pilot RCT estimated a mean improvement from baseline of 6.7 points in UPDRS-III relative to usual care. From McCrone et al. (2007), over the full spectrum of UPDRS-III scores, it was estimated that a one-point reduction in UPDRS-III was worth an average $143.55 in cost savings from lower resource utilisation. Additionally, from a NICE HTA assessment of deep brain simulation, it was estimated that health related quality of life increases by 0.02 for every point reduction in UPDRS-III. The estimated incremental benefit of PKG plus MDS, relative to MDS alone therefore amounted to 0.13 QALYs. Improved disease management contributed to total cost savings of $962 per patient from lower resource utilisation.

Conclusions: This analysis demonstrates the small incremental benefit needed for PKG to be cost-effective in the management of Parkinson’s disease compared to current usual care. If the pilot clinical results are confirmed in other trials, the PKG would likely be cost saving overall based on this model.

References: Kotschet, Farzanehfar, Braybrook, Horne. Objective Measurement in Clinical Care of Patients with Parkinson’s disease: an RCT using the PKG. Presented MDS Conference Vancouver June 2017.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/pilot-economic-evaluation-of-personal-kinetigraph-pkg-for-management-of-parkinsons-disease-in-australia/