The total cost of Parkinson’s disease to individuals, families and the U.S. government is $51.9 billion every year, according to a new estimate released Thursday by the Michael J. Fox Foundation for Parkinson’s Research.

The amount is almost twice as much as previous estimates and for the first time includes the various ways the disease affects people’s finances and their ability to participate in the labor force. The foundation said the study, “The Economic Burden of Parkinson’s Disease,” is the most comprehensive assessment to date of the disease’s financial effects on patients, care partners, payers, employers, healthcare systems and government programs.

“This data will help facilitate a new level of outcome-driven conversations with members of Congress who oversee federal programs that affect the lives of the one million people with Parkinson’s in the United States,” said Michael J. Fox Foundation CEO Todd Sherer, Ph.D. “Investing more in research toward better treatments and a cure will ultimately relieve the burden on already-strained programs like Medicare, Medicaid and Social Security.”

Of the $51.9 billion annual cost, $25.4 billion is attributable to direct medical costs such as hospitalizations and medication, and $26.5 billion is attributable to nonmedical costs such as missed work, lost wages, early forced retirement and family caregiver time, according to the foundation.

The federal government alone spends almost $25 billion annually in caring for people living with Parkinson’s, the foundation said. Approximately $2 billion of that amount is paid by Social Security, and the remaining $23 billion is in Medicare costs; an estimated 90% of people with Parkinson’s are Medicare beneficiaries, the research found.

The totals are based on publicly available data from Medicare, the Centers for Disease Control and Prevention and the Census Bureau, as well as other survey tools. The research was conducted and published with support from Parkinson’s Foundation, the American Parkinson Disease Association, The Parkinson Alliance, AbbVie, ACADIA Pharmaceuticals, Acorda Therapeutics, Adamas Pharmaceuticals and Biogen.