Access to Parkinson's disease treatments in the Middle East: a multi-national survey of availability, affordability, and utilization patterns.

BACKGROUND

Parkinson's disease (PD) is an increasing public health challenge in the Middle East, yet regional data on access to therapies and services remain limited. Understanding the gaps in PD treatment availability, affordability, and prescription frequency is necessary for improving care delivery and regional policy development.

OBJECTIVES

Evaluating the availability, affordability, and utilization of disease-related pharmacological treatments, surgical, device-assisted therapies, and rehabilitative services across multiple Middle Eastern countries.

METHODS

A cross-sectional, web-based survey was distributed to physicians with expertise in movement disorders across participating countries in the Middle East. The survey assessed three domains of availability, cost, and utilization of key medications, surgical interventions, and specialized PD services.

RESULTS

Thirty-one respondents from nine Middle Eastern countries, including 44% movement-disorder specialists. Medication availability was 65.4%, affordability 68.6%, and prescription 52% across the included countries. Levodopa was nearly universally available (98%), whereas newer dopamine agonists, MAO-B inhibitors, and COMT inhibitors were available inconsistently. Advanced therapies demonstrated disparities; botulinum toxin and deep-brain stimulation were available in high-income countries but not frequently used, while infusion therapies were mostly unavailable. Telemedicine uptake was moderate; genetic testing was cost-restricted. Although general rehabilitation was available, PD-specific services were limited. Affordability constrained equitable care. Qatar had the highest reported prescription frequency of PD medications among the countries.

CONCLUSIONS

The survey highlights disparities in access to essential PD therapies across the Middle East. Variable availability, costs, and limited specialized services prevent optimal care, urging the need for stronger regional policies, improved insurance coverage, and expanded clinical training to improve equity in PD management.