Objective: To evaluate the perception of the annual direct costs (medications, medical
appointments, rehabilitation, transportation) associated with the treatment for patients with
PD in the Brazilian Amazon.

Background: Parkinson’s disease (PD) is a high-cost disease. A study in Singapore proved that a
patient with PD spends approximately U$ 10,129 per year, while the economic burden to the
country varied between U$ 23 and 41 millions per year, corresponding to 1.2% of the budget
destined to the health cost. In the wealthiest region of Brazil (São Paulo), a previous study
showed that patients with PD have an average annual direct cost of U$ 3,172. There are no
data about the impact of direct costs of PD on patients living in poorer regions of Brazil, as the
Brazilian Amazon.

Method: Cross-sectional study with PD patients who were attended at an outpatient clinic of
Movement Disorders in Belém, Northern Brazil. Epidemiologic and clinical data were collected.
The costs for the disease were collected through a questionnaire adapted by the researchers.

Results: 42 patients with PD were evaluated. Median age at evaluation was 61 years, and
median disease duration was 7 years. The majority of patients (76,3%) was classified as early
stage (Hoehn & Yahr scale < 2). About 64% of the participants did not have health insurance
and 45% of patients had an income between 1 and 2 minimum wages per month (Brazilian
minimum wage was U$ 194,92 at the time of the study). Median direct annual cost was U$
1,367.78 per patient, and 64.5% of this cost was spent with antiparkinsonian medication
(38.4% financed by the public Brazilian Health System, and 26,1% bought by the patients).
Dopaminergic agonists alone corresponded to 50.9% of the medications cost. Rehabilitation
and transportation costs corresponded to 14.6% and 10.1%, respectively.

Conclusion: PD is associated with high direct annual costs, even for a population in social
vulnerability. The economic burden caused by the disease has a critical impact on their well-
being, especially due to high expenses with medications.

This abstract reports data partially presented at XXII Brazilian Congress of Geriatrics and Gerontology, Annual Brazilian Society of Geriatrics and Gerontology Meeting, Brazil, 04th 06nd March 2021.

References: Martinez-Martín P, Rodriguez-Blazquez C, Paz S, Forjaz MJ, Frades-Payo B, Cubo E, et al. Parkinson symptoms and health related quality of life as predictors of costs: a longitudinal observational study with linear mixed model analysis. PloS one. 2015;10(12):e0145310. Zhao Y, Tan L, Li S, Au W, Seah S, Lau P, et al. Economic burden of Parkinson’s disease in Singapore. European journal of neurology. 2011;18(3):519-26. Bovolenta TM, de Azevedo Silva SM, Arb Saba R, Borges V, Ferraz HB, Felicio AC. Systematic Review and Critical Analysis of Cost Studies Associated with Parkinson’s Disease. Parkinsons Dis. 2017;2017:3410946. doi: 10.1155/2017/3410946. Epub 2017 Mar 5. PMID: 28357150; PMCID: PMC5357537.

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