Prevalence and costs of parkinsonian syndromes associated with orthostatic hypotension

Objective: To measure the frequency of and direct costs related to parkinsonian syndromes associated with orthostatic hypotension (OH). Patients/Methods: Patients over 45 years using at least one antiparkinsonian drug (excluding piribedil or anticholinergics prescribed alone) were identified from the Haute-Garonne Social Security prescription database and separated in two groups according to simultaneous prescription (OH group) or not (control group) of drugs for orthostatic hypotension. Direct medical costs were analysed retrospectively, over a 6-month period, from the health care payer's perspective. Results: Eighty-eight patients (9.1%) out of 971 parkinsonian also received antihypotensive drugs. Direct medical costs were significantly higher in OH than in control group (4.425 vs. 3.074 (sic)/patient/6 months, p < 0.05). Beside hospitalisation and ancillary cares, drugs accounted for highest expenses (989 vs. 781 (sic)/patient/6 months in control group) since use of controlled-release levodopa formulations or dopamine agonists was higher in OH group. Conclusion: Occurrence of OH is associated with higher medical expenditure in parkinsonian syndromes.