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Cost Effectiveness of Pharmacotherapies in Early Parkinson’s Disease

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Abstract

Parkinson’s disease is one of the most common chronic neurodegenerative diseases. The progression of disease and the psychosocial consequences exert a major impact on patients’ health-related quality of life. Although levodopa provides the best symptomatic benefit with the fewest short-term adverse effects, long-term treatment results in motor complications that are associated with both higher costs and considerable increase in patients’ discomfort. The introduction of dopamine agonists early in the treatment of Parkinson’s disease leads to a delay of these motor complications, but the treatment is associated with higher costs.

In this review we evaluate available cost-effectiveness analyses of the dopamine agonists pramipexole, pergolide, bromocriptine, ropinirole, cabergoline and levodopa in the treatment of early Parkinson’s disease. Considerable method-ological differences in the identified studies complicate a comparison and impede clear evidence as to which dopamine agonist treatment is the most cost effective in early Parkinson’s disease. Novel head-to-head comparisons considering the actual treatment guidelines are necessary to identify the most cost-effective alternative in treating de novo Parkinson’s disease patients.

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Notes

  1. 1 Withdrawn from the US market in March 2007 because of the potential for heart valve damage.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. Karla Eggert, Wolfgang Oertel and Richard Dodel have received honoraria from pharmaceutical companies and are involved in clinical trials in Parkinson’s disease performed by different pharmaceutical companies. Karla Eggert has worked as a consultant for Orion, UCB-Schwarz Pharma, Solvay, Valeant, GlaxoSmithKline, Desitin, Orphane Europe and Teva. She has received scientific grants from the Germany Ministry of Education and Health, the Pitzer Foundation and the Rhön Foundation. Wolfgang Oertel has received consultancy fees and/or honoraria from Boehringer Ingelheim, Solvay, Orion, GlaxoSmithKline, sanofi-aventis, Bayer-Schering, UCB-Schwarz Pharma, Teva, Novartis, Eisai, Medtronic, Desitin, Servier and GE Health. Richard Dodel has received funding from the following companies in respect to economic studies: Solvay, Medtronic, Novartis, Merck and Schering. Jens Reese has no potential conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Neurology, Philipps-University Marburg, Rudolf-Bultmannstr. 8, Marburg, 35039, Germany

    Karla M. Eggert, Jens P. Reese, Wolfgang H. Oertel &  Richard Dodel

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  1. Karla M. Eggert
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Correspondence to Richard Dodel.

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Eggert, K.M., Reese, J.P., Oertel, W.H. et al. Cost Effectiveness of Pharmacotherapies in Early Parkinson’s Disease. CNS Drugs 22, 841–860 (2008). https://doi.org/10.2165/00023210-200822100-00005

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