Cost-effectiveness analysis of entacapone in Parkinson's disease: a Markov process analysis.

Abstract

OBJECTIVE:

The objective of this study was to examine the cost-effectiveness of a complementary treatment with entacapone versus usual care only in patients with Parkinson's disease.

METHODS:

The setting for this study was the Netherlands. A Markov process model was constructed to model the average quality-adjusted life years (QALYs) and the costs of both treatments. The model examined a period of 5 years in order to capture the influence of symptom improvement and disease progression. Data for the construction of the model were derived from published literature, including large, multicenter, randomized clinical trials in patients with end-of-dose motor fluctuations. Costs were obtained from published sources.

RESULTS:

The results of the baseline analysis showed that the use of entacapone as complementary therapy in Parkinson's disease slightly decreased the total average discounted costs from NLG 111,317 to NLG 110,038, while effectiveness increased from 2.42 to 2.56 QALYs (a 6% increase). In addition, entacapone substantially increased time without severe fluctuations by 0.63 years. Sensitivity analyses confirmed the robustness of these findings.

CONCLUSION:

The study shows that entacapone is a cost-effective treatment in patients with Parkinson's disease: entacapone yields higher effectiveness in terms of both effectiveness measures (time without severe fluctuations and QALYs), while costs remain quite similar to those for usual care. The additional drug costs for entacapone are offset by reductions in other costs.

• Authors: M J Nuijten, P van Iperen, C Palmer, B J van Hilten, E Snyder
• Journal: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (Value Health) 2001 Jul-Aug Vol. 4 Issue 4 Pg. 316-28 ISSN: 1098-3015 [Print] United States
• PMID: 11705299 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiparkinson Agents
• Catechols
• Nitriles
• Levodopa
• entacapone

Topics

• Aged
• Antiparkinson Agents (economics, therapeutic use)
• Catechols (economics, therapeutic use)
• Cost of Illness
• Cost-Benefit Analysis
• Drug Costs (statistics & numerical data)
• Economics, Pharmaceutical
• Efficiency
• Female
• Health Care Costs (statistics & numerical data)
• Humans
• Levodopa (economics, therapeutic use)
• Male
• Markov Chains
• Middle Aged
• Netherlands
• Nitriles
• Parkinson Disease (drug therapy, economics)
• Quality-Adjusted Life Years
• Treatment Outcome