Parkinson’s disease costs Europe €22.8 billion annually as cases rise, study finds

Parkinson’s disease is already costing Europe more than €22 billion a year, and the bill is expected to grow as the continent’s population ages and the number of people living with the condition continues to rise. A new analysis published in Movement Disorders estimates that Parkinson’s disease generated an annual societal burden of €22.8 billion across Europe in 2019. Adjusted for inflation, that figure would equal approximately €28.8 billion in 2025 prices. The study offers one of the most detailed attempts yet to quantify the financial consequences of Parkinson’s disease across individual European countries, extending the discussion beyond hospital spending to include social care, unpaid family support and lost productivity.

Researchers estimate that about 2.2 million adults were living with Parkinson’s disease across 47 European countries in 2019. The neurological disorder develops when dopamine-producing nerve cells in a region of the brain called the substantia nigra progressively deteriorate. Dopamine is essential for the smooth control of movement, and its loss can lead to tremor, muscular rigidity, slowness of movement and problems with balance. Parkinson’s disease can also affect sleep, mood, cognition, speech and the autonomic nervous system. Because the condition is chronic and usually worsens over time, many people eventually require combinations of medication, rehabilitation, home support, assisted living or help from relatives.

The analysis divided the economic burden into three main categories. Direct medical and non-medical costs accounted for €17.3 billion, or roughly 76% of the total. These expenses include consultations, diagnostic procedures, medicines, hospital treatment, rehabilitation, professional social care, transportation and modifications to the home, such as bathroom adaptations or mobility equipment. The figure demonstrates that the financial impact of Parkinson’s disease extends well beyond prescriptions and specialist appointments. As symptoms become more complex, people may need multidisciplinary care involving neurologists, nurses, physiotherapists, occupational therapists, speech and language specialists, psychologists and social-care professionals.

A further €4.4 billion was attributed to informal care, representing almost 19% of the overall burden. Informal care includes unpaid assistance provided by family members, partners, friends and other personal networks. Relatives may help with dressing, bathing, eating, medication schedules, transportation, household tasks and communication with healthcare services. They may also supervise people experiencing falls, confusion or changes in judgment. Economists assign a monetary value to this work because it replaces services that would otherwise need to be purchased or publicly funded. Yet the calculated figure may still underestimate the true human cost, since unpaid caregivers can experience exhaustion, anxiety, depression, reduced working hours and long-term financial insecurity.

The study estimated another €1 billion in indirect costs caused by lost productivity. Parkinson’s disease is most common in older adults, but it can also begin during working age. Symptoms such as slowed movement, impaired concentration, fatigue, speech difficulties and medication fluctuations may make it difficult for people to maintain full-time employment. Caregivers may also reduce their working hours or leave employment to support a relative. These effects are particularly important when assessing a disease whose prevalence is increasing before people reach advanced age. Productivity calculations generally capture measurable earnings or work losses, but they do not fully reflect the loss of professional identity, social participation or future career opportunities.

Europe’s rising Parkinson’s prevalence is a major reason why researchers expect pressure on health and social-care systems to intensify. The condition’s prevalence has nearly doubled since 1990, increasing from 135 to 247 cases per 100,000 people. Population ageing is the central driver: as more people survive into older age, more individuals reach the period of life in which neurodegenerative disorders become more common. Improved recognition and advances in diagnosis may also contribute to the increase by identifying cases that previously went unrecorded. Researchers describe Parkinson’s disease as the world’s second most common and fastest-growing neurodegenerative disorder, following a broader global trend that is transforming the demand for neurological care.

The economic burden was not distributed evenly across the continent. Germany recorded the highest national cost, at €5.7 billion, followed by France at €5.3 billion, Italy at €2.6 billion, Spain at €1.9 billion and the United Kingdom at €1.6 billion. Together, these five countries represented approximately three-quarters of the total European burden. Their large populations explain part of the concentration, but the researchers also point to higher age-related prevalence, more expensive healthcare systems and greater availability of economic data. A higher national total does not necessarily mean that patients in one country receive poorer care; it may instead reflect the size of the affected population, the intensity of services provided and the prices attached to those services.

The estimates were produced through the Cost of Illness in Neurology in Europe, or COIN-Eu, initiative led by the European Academy of Neurology. Researchers combined 2019 prevalence estimates from the Global Burden of Disease Study with cost information identified through a systematic review of European cost-of-illness research. Fourteen eligible publications were included. When country-specific evidence was unavailable, the investigators estimated costs using World Bank income categories and national economic indicators. They then standardised the results to 2019 values and converted national costs into euros using purchasing power parities, a method designed to compare the relative purchasing power of currencies rather than relying solely on market exchange rates. Clinical experts affiliated with the European Academy of Neurology reviewed the resulting estimates.

The researchers caution that the headline figure is substantial but incomplete. Thirteen of the 14 eligible cost studies came from high-income countries, and no eligible primary cost data were available from lower-middle-income countries. As a result, the €22.8 billion estimate covers 43 of the 47 countries assessed for prevalence, rather than the entire group. Missing data create uncertainty because countries with fewer published studies may have very different healthcare structures, wage levels, patterns of family caregiving and access to diagnosis. Imputation allows researchers to generate provisional estimates, but it cannot replace direct national evidence. More consistent methods for measuring costs would make future comparisons more reliable and help governments determine where investments in diagnosis, treatment, rehabilitation and caregiver support could have the greatest effect.

The study’s message is therefore both financial and human: Parkinson’s disease is not simply a disorder managed in neurology clinics, but a long-term challenge that reaches into homes, workplaces, hospitals and public budgets. The findings give policymakers a way to estimate future demand as Europe’s demographic profile changes, while also making visible the contribution of unpaid caregivers whose work is often excluded from conventional healthcare accounts. Early diagnosis, coordinated multidisciplinary treatment, fall prevention, rehabilitation and practical support for families could all influence the trajectory of future costs, although the analysis does not measure the savings associated with specific interventions. As the number of people living with Parkinson’s disease continues to rise, the researchers argue that reliable economic evidence will be essential for planning services capable of protecting both patients and the people who care for them.