Cabergoline versus levodopa monotherapy: A decision analysis

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Abstract
We evaluated the incremental cost‐effectiveness of cabergoline compared with levodopa monotherapy in patients with early Parkinson's disease (PD) in the German healthcare system. The study design was based on cost‐effectiveness analysis using a Markov model with a 10‐year time horizon. Model input data was based on a clinical trial “Early Treatment of PD with Cabergoline” as well as on cost data of a German hospital/office‐based PD network. Direct and indirect medical and nonmedical costs were included. Outcomes were costs, disease stage, cumulative complication incidence, and mortality. An annual discount rate of 5% was applied and the societal perspective was chosen. The target population included patients in Hoehn and Yahr Stages I to III. It was found that the occurrence of motor complications was significantly lower in patients on cabergoline monotherapy. For patients aged ≥60 years of age, cabergoline monotherapy was cost effective when considering costs per decreased UPDRS score. Each point decrease in the UPDRS (I‐IV) resulted in costs of €1,031. Incremental costs per additional motor complication‐free patient were €104,400 for patients <60 years of age and €57,900 for patients ≥60 years of age. In conclusion, this decision‐analytic model calculation for PD was based almost entirely on clinical and observed data with a limited number of assumptions. Although costs were higher in patients on cabergoline, the corresponding cost‐effectiveness ratio for cabergoline was at least as favourable as the ratios for many commonly accepted therapies. © 20032003 Movement Disorder Society
Funding Information
  • Pharmacia Corporation, USA
  • Kompetenznetzwerk Parkinson-Syndrome, granted by the German Federal Ministry for Education and Research (BMBF grant 01GI9901/1)