Cost-Effectiveness of Carbidopa-Levodopa Enteral Suspension for Advanced Parkinson's Disease in the United States

Mov Disord. 2023 Dec;38(12):2308-2312. doi: 10.1002/mds.29624. Epub 2023 Oct 25.

Abstract

Background: Carbidopa/levodopa enteral suspension (CLES) is indicated for the treatment of advanced Parkinson's disease (aPD) with severe motor fluctuations.

Objective: To determine the cost, quality-adjusted life years (QALY), and cost-effectiveness of CLES compared to the standard-of-care (SoC) for aPD patients in the United States (US), using real-world data.

Methods: A published Markov model, comprising of 25 health states and a death state, (defined by a combination of the Hoehn and Yahr scale and waking time spent in OFF-time) was adapted to estimate the benefits for CLES versus oral SoC over a patient's lifetime in the US healthcare setting. Clinical inputs were based on a clinical trial and a registry study; utility inputs were sourced from the Adelphi-Disease Specific Programmes.

Results: CLES compared to SoC was associated with incremental costs ($1,031,791 vs. $1,025,180) and QALY gain (4.61 vs. 3.76), resulting in an incremental cost-effectiveness ratio of $7711/QALY.

Conclusion: CLES is a cost-effective treatment for aPD patients with medication resistant motor fluctuations. © 2023 AbbVie, Inc and The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; United States; carbidopa/levodopa enteral suspension; cost-effectiveness; economic evaluation.

MeSH terms

  • Antiparkinson Agents
  • Carbidopa / therapeutic use
  • Cost-Benefit Analysis
  • Drug Combinations
  • Gels / therapeutic use
  • Humans
  • Levodopa* / therapeutic use
  • Parkinson Disease* / drug therapy
  • United States

Substances

  • Levodopa
  • Carbidopa
  • Antiparkinson Agents
  • Drug Combinations
  • Gels

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