Pramipexole v. Levodopa as Initial Treatment for Parkinson’s Disease: A Randomized Clinical-Economic Trial

Katia Noyes, Andrew W. Dick and Robert G. Holloway
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Andrew W. Dick: Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York.
Robert G. Holloway: Department of Community and the Department of Neurology, University of Rochester School of Medicine, Rochester, New York; 601 Elmwood Ave., Box 673, Rochester, NY 14642; telephone: (585) 273-4241robert.holloway@ctcc.rochester.edu.

Medical Decision Making, 2004, vol. 24, issue 5, 472-485

Abstract: Purpose . To determine the 2-year incremental cost effectiveness of initial pramipexole treatment compared with initial levodopa treatment in patientswith early Parkinson’s disease (PD) . Methods . 301 subjects with early PD were randomized to either pramipexole or levodopa and followed every 3 months over a 2-year period. Costs were assigned to patient collected health utilization data using a variety of methods. Health state preferences were estimated using the EuroQol . Results . Pramipexole strategy was an estimated $2,138 (SE = $1,182) more expensive than levodopa strategy. The incremental cost-effectiveness of pramipexole compared with levodopa was $106,900/QALY (EQ-5D), compared with pramipexole being dominated by levodopa using the EQVAS . Conclusions .Although considerable uncertainty exists in the 2-year cost-effectiveness of initial pramipexole compared with initial levodopa in the treatment of early PD, our estimates suggest that pramipexole may not be welfare enhancing during the first 2 years of treatment. If initial pramipexole results in long-term improvements in quality of life, its cost-effectiveness will become more favorable.

Keywords: Parkinson’s disease; levodopa; pramipexole; randomized clinical trials; quality of life; cost-effectiveness; net benefit; societal welfare (search for similar items in EconPapers)
Date: 2004
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:24:y:2004:i:5:p:472-485

DOI: 10.1177/0272989X04268960

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