{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T08:26:42Z","timestamp":1793780802309,"version":"4.6.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Parkinson\u2019s disease (PD) is an incurable, progressive, neurodegenerative disorder. As PD advances and symptoms progress, patients become increasingly dependent on family and carers. Traditional cost-effectiveness analyses (CEA) only consider patient and payer-related outcomes, failing to acknowledge impacts on families, carers, and broader society. This novel Social Return on Investment (SROI) analysis aimed to evaluate the broader impact created by improving access to levodopa (LD) device-aided therapies (DATs) for people living with advanced PD (aPD) in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A forecast SROI analysis over a three-year time horizon was conducted. People living with aPD and their families were recruited for qualitative interviews or a quantitative survey. Secondary research and clinical trial data was used to supplement the primary research. Outcomes were valued and assessed in a SROI value map in Microsoft Excel\u2122. Financial proxies were assigned to each final outcome based on willingness-to-pay, economic valuation, and replacement value. Treatment cost inputs were sourced from Pharmaceutical Benefits Schedule (PBS) and Medicare Benefits Scheme (MBS) published prices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-four interviews were conducted, and 55 survey responses were received. For every $1 invested in access to LD-based DATs in Australia, an estimated $1.79 of social value is created. Over 3\u2009years, it was estimated $277.16 million will be invested and $406.77 million of social return will be created. This value is shared between people living with aPD (27%), their partners (22%), children (36%), and the Australian Government (15%). Most of the value created is social and emotional in nature, including reduced worry, increased connection to family and friends, and increased hope for the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Investment in LD-based DATs is expected to generate a positive social return. Over 50% of the value is created for the partners and children of people living with aPD. This value would not be captured in traditional CEA. The SROI methodology highlights the importance of investing in aPD treatment, capturing the social value created by improved access to LD-based DATs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1351808","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T15:24:41Z","timestamp":1718983481000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Levodopa-based device-aided therapies for the treatment of advanced Parkinson\u2019s disease: a social return on investment analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Inez","family":"Denham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne","family":"Maurin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Deltetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Stefanie","family":"Mikolaizak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny B.","family":"Waern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colman","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/jama.2019.22360","article-title":"Diagnosis and treatment of Parkinson disease: a review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"183","DOI":"10.18773\/austprescr.2012.084","article-title":"Management of Parkinson\u2019s disease","volume":"35","author":"Sellbach","year":"2012","journal-title":"Aust Prescr"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1037\/rep0000313","article-title":"The relationship between Parkinson's disease symptoms and caregiver quality of life","volume":"65","author":"Henry","year":"2020","journal-title":"Rehabil Psychol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1111\/j.1365-2702.2012.04146.x","article-title":"Experiences of caregivers of people with Parkinson's disease in Singapore: a qualitative analysis","volume":"21","author":"Tan","year":"2012","journal-title":"J Clin Nurs"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/cns.13549","article-title":"Quality of life in Parkinson's disease: a systematic review and meta-analysis of comparative studies","volume":"27","author":"Zhao","year":"2021","journal-title":"CNS Neurosci Ther"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"309","DOI":"10.2217\/nmt-2020-0021","article-title":"Application of the '5-2-1\u2032 screening criteria in advanced Parkinson's disease: interim analysis of DUOGLOBE","volume":"10","author":"Aldred","year":"2020","journal-title":"Neurodegener Dis Manag"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"100075","DOI":"10.1016\/j.prdoa.2020.100075","article-title":"Characteristics of advanced Parkinson's disease patients seen in movement disorder clinics - Australian results from the cross-sectional OBSERVE study","volume":"4","author":"Evans","year":"2021","journal-title":"Clin Park Relat Disord"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1093\/brain\/123.11.2297","article-title":"Dyskinesias and motor fluctuations in Parkinson's disease: a community-based study","volume":"123","author":"Schrag","year":"2000","journal-title":"Brain"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/S1474-4422(10)70218-0","article-title":"Levodopa-induced dyskinesias in patients with Parkinson's disease: filling the bench-to-bedside gap","volume":"9","author":"Calabresi","year":"2010","journal-title":"Lancet Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1016\/S1474-4422(22)00400-8","article-title":"Safety and efficacy of continuous subcutaneous foslevodopa-foscarbidopa in patients with advanced Parkinson's disease: a randomised, double-blind, active-controlled, phase 3 trial","volume":"21","author":"Soileau","year":"2022","journal-title":"Lancet Neurol"},{"key":"ref12","year":"2015"},{"key":"ref13","volume-title":"A guide to Social Return on Investment","author":"Nicholls","year":"2012"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2773","DOI":"10.1212\/WNL.98.18_supplement.2773","article-title":"Long-term motor and non-motor symptom benefits in patients with advanced Parkinson\u2019s disease treated with levodopa-carbidopa intestinal gel: final analysis","volume":"98","author":"Chaudhuri","year":"2022","journal-title":"Neurology"},{"key":"ref15","year":"2023"},{"key":"ref16","year":"2023"},{"key":"ref17","year":"2024"},{"key":"ref18","volume-title":"A bridge towards inclusion","author":"Filippo Montesi","year":"2018"},{"key":"ref19","volume-title":"M15-736 clinical study report","year":"2021"},{"key":"ref20","year":"2016"},{"key":"ref21","year":"2024"},{"key":"ref22","volume-title":"PBS expenditure and prescriptions report: 1 July 2020 to 30 June 2021","year":"2020"},{"key":"ref23","year":"2022"},{"key":"ref24","year":"2023"},{"key":"ref25","year":"2018"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.2147\/NDT.S213917","article-title":"Impact of non-motor symptoms in Parkinson's disease: a PMDAlliance survey","volume":"15","author":"Hermanowicz","year":"2019","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s40273-022-01132-y","article-title":"The cost effectiveness of levodopa-carbidopa intestinal gel in the treatment of advanced Parkinson\u2019s disease in England","volume":"40","author":"Chaudhuri","year":"2022","journal-title":"PharmacoEconomics"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1080\/13696998.2017.1379411","article-title":"The cost-effectiveness of levodopa\/carbidopa intestinal gel compared to standard care in advanced Parkinson\u2019s disease","volume":"20","author":"Lowin","year":"2017","journal-title":"J Med Econ"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/imj.12656","article-title":"Deep brain stimulation for Parkinson disease in Australia: current scientific and clinical status","volume":"45","author":"Poortvliet","year":"2015","journal-title":"Intern Med J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2017\/5932675","article-title":"Cost of living with Parkinson\u2019s disease over 12 months in Australia: a prospective cohort study","volume":"2017","author":"Bohingamu Mudiyanselage","year":"2017","journal-title":"Parkinsons Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1351808\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T09:53:25Z","timestamp":1719222805000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1351808\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,6]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2024.1351808"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1351808","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,6]]},"article-number":"1351808"}}