Objective: To quantify the potential cost savings and quality adjusted life years (QALYs) gained for people with Parkinson’s disease in Australia whose oral therapy was adjusted with guidance from the Personal KinetiGraph (PKG).

Background: The PKG is a wrist-worn medical device that collects a patient’s movement data using a digital accelerometer. The PKG is an objective home evaluation of the motor symptoms of PD, which assists clinicians to optimise therapy.

Methods: A Northern Tasmania study [1] assessed motor function and reported patient outcomes for a Parkinson’s disease patient cohort managed by a Movement Disorder clinic with PKG. The change in patient outcomes with PKG is translated to savings in resource utilization costs and improved quality of life. Costs and outcomes were assessed over a model horizon of one year.

Results: In the Northern Tasmania study, a total of 80 of 103 enrolled patients were found with uncontrolled disease, 33 of the 80 were treated with oral therapy. Among the 33 patients who were treated with oral therapy with the assistance of PKG, decreases were observed in: mean UPDRS-II (-4; 9-13), mean UPDRS-III (-3; 36-39), Percent Over Target (-8, 64-73) and PDQ39 (10, 19-29). Using a study by McCrone et al. (2007)[2], it was estimated that over the relevant range of UPDRS-II scores, a one-point reduction in UPDRS-II correlates with an average of $430 in cost savings from lower resource utilisation. Improved disease management contributed to total resource utilisation cost savings of $1,719.42 per patient over a 12-month period. Additionally, from a recent NICE PD Guideline Health Economic Report [3], a linear mixed effects model estimated EQ-5D as a function of clinical variables of patients with PD. Using PKG efficacy for UPDRS-III (-3),UPDRS-II (-4), PTO(-8) and PDQ39 (-10), a QALY gain of between 0.10-0.12 was estimated over a 12-month period.

Conclusions: This analysis quantifies the economic cost savings and incremental outcomes in patients who have their medication changed following assessment by PKG. For inclusion in an economic evaluation of PKG the proportion of patients with changed management needs to be considered.

References: 1. Farzanehfar et al. Objective Measurement in Routine Care of People with Parkinson’s Disease improves outcomes. Abstract submitted 2018 IMDS Conference Hong Kong. Data on file. 2. McCrone P, Allcock LM, Burn DJ. Predicting the cost of Parkinson’s disease. Mov Disord. 2007 Apr 30;22(6):804-12. 3. NICE Guideline: Parkinson’s Disease in Adults: Appendix F Full Health Economic Report [Table 29]. July 2017. Accessed at https://www.nice.org.uk/guidance/ng71/evidence/appendix-f-he-report-pdf-4538466259.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/costs-and-outcomes-for-parkinsons-disease-patients-who-have-their-management-adjusted-by-personal-kinetigraph-pkg/