Monday 28 November 2011

Call for Medisave to cover Parkinson's disease

Researchers cite increased risks and heavy cost burden as population ages
By Judith Tan, The Sunday Times, 27 Nov 2011

Citing their research on Parkinson's disease, clinician-scientists - with an eye on the costs as the number of elderly people grows - are calling for the use of Medisave to manage the condition.

These researchers from the National Neuroscience Institute (NNI) had found and isolated a genetic variant of a gene called LRRK2.

Significantly, this genetic variant is linked to a twofold increased risk of the disease among the majority Chinese population here.

The scientists also worked out the heavy cost that will burden caregivers and the health system as more and more people succumb to Parkinson's. Hence, the use of Medisave can help cut costs all round.

Parkinson's is a brain-wasting disease characterised by uncontrollable tremors. After Alzheimer's disease, it is the next most common neurodegenerative disease here, affecting three to four people in every 1,000 aged above 50.

This number goes up to one in every 100 for people here aged above 70.

Dr Louis Tan, a senior consultant in the NNI's department of neurology, said there are 300 new cases each year. 'This number is predicted to increase to 500 every year by the year 2030,' he said.

Professor Tan Eng King, senior consultant neurologist and clinician-scientist at the NNI, said 10 per cent to 20 per cent of the cases are due to abnormal genes. For the majority, the cause cannot be identified.

Funding of $10 million for the research on the disease came from the Singapore Millennium Foundation.

The Sunday Times understands that this was 80 per cent of the $12.5 million requested, after the researchers failed to secure money from agencies such as the National Medical Research Council and the National Research Foundation.

Doctors say the average life expectancy of Parkinson's patients is about the same as that for people without the disease.

The progression of symptoms of the disease, however, may take 20 years or more.

In some people, the disease progresses more quickly and there is no way to predict what course it will take.

There is no known cure, but with proper medication and rehabilitative exercises, those who have Parkinson's can maintain their physical functions and manage their conditions to live active normal lives.

But any delay in diagnosis and intervention can impact future costs.

With data from the NNI's studies, coupled with consideration of Singapore's rapidly ageing population, the researchers felt that using Medisave to manage the degenerative disease will definitely help ease the burden for all.

There are currently 3,284 people with Parkinson's here, with their individual medical bills alone amounting to about $11,300 yearly.

Based on this estimate, the annual cost for Singapore would be around $37 million for medication alone.

'This is about 1 per cent of Singapore's total health-care budget. Given our rapidly ageing population, these costs will soar to almost triple by 2030,' Prof Tan said.

To date, the total number of chronic diseases covered by Medisave is 10.
These are diabetes, high blood pressure, stroke, lipid disorders, chronic obstructive pulmonary disease, asthma, schizophrenia, major depression, dementia and bipolar disorder.


Research shows that it costs a patient with Parkinson's disease more than $11,300 a year to treat the affliction.

With the estimate that some 3,300 people are already down with disease here, this means the yearly cost of treating it is about $37 million, or about

1 per cent of Singapore's total health-care budget.

'But this is merely the cost of medicines,' said Associate Professor Tan Eng King, senior consultant neurologist and clinician-scientist at the National Neuroscience Institute. 'Incidentals such as consultation fee, cost of transport or loss of earning for both the patient and the caregiver are not factored in.'

He adds that costs will nearly triple by 2030 due to the Republic's ageing population.
Singapore has, after Japan, the fastest-ageing population in the world. By 2030, one in five people here will be 65 or older.

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