TY - JOUR
T1 - Cost-Effectiveness and Cost-Utility of Early Levodopa in Parkinson's Disease
AU - Verschuur, Constant V. M.
AU - Suwijn, Sven R.
AU - de Haan, Rob J.
AU - Boel, Judith A.
AU - Post, Bart
AU - Bloem, Bas R.
AU - van Hilten, Johannes J.
AU - van Laar, Teus
AU - Tissingh, Gerrit
AU - Munts, Alexander
AU - Dijkgraaf, Marcel G. W.
AU - de Bie, Rob M. A.
N1 - Funding Information: The Levodopa in Early Parkinson’s disease (LEAP) study was supported by unrestricted grants from ZonMw (Dutch governmental fund for health research, project number 0-82310-97-11031), Parkinson Vereniging (Dutch patient organization), Stichting Parkinsonfonds, and Stichting Parkinson Nederland (both Dutch funding associations for Parkinson’s disease-research). Levodopa/carbidopa capsules and tablets and matching placebo capsules and tablets were produced by and delivered to the participating patients by ACE Pharmaceuticals (Zeewolde, the Netherlands). Publisher Copyright: © 2022 - The authors. Published by IOS Press.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: In the Levodopa in EArly Parkinson's disease (LEAP) study, 445 patients were randomized to levodopa/carbidopa 100/25 mg three times per day for 80 weeks (early-start) or placebo for 40 weeks followed by levodopa/carbidopa 100/25 mg three times per day for 40 weeks (delayed-start). OBJECTIVE: This paper reports the results of the economic evaluation performed alongside the LEAP-study. METHODS: Early-start treatment was evaluated versus delayed-start treatment, in which the cost-effectiveness analysis (CEA) and the cost-utility analysis (CUA) were performed from the societal perspective, including health care costs among providers, non-reimbursable out-of-pocket expenses of patients, employer costs of sick leave, and lowered productivity while at work. The outcome measure for the CEA was the extra cost per unit decrease on the Unified Parkinson's Disease Rating Scale 80 weeks after baseline. The outcome measure for the CUA was the extra costs per additional quality adjusted life year (QALY) during follow-up. RESULTS: 212 patients in the early-start and 219 patients in the delayed-start group reported use of health care resources. With savings of € 59 per patient (BCa 95% CI: -829, 788) in the early-start compared to the delayed-start group, societal costs were balanced. The early-start group showed a mean of 1.30 QALYs (BCa 95% CI: 1.26, 1.33) versus 1.30 QALYs (BCa 95% CI: 1.27, 1.33) for the delayed-start group. Because of this negligible difference, incremental cost-effectiveness and cost-utility ratios were not calculated. CONCLUSION: From an economic point of view, this study suggests that early treatment with levodopa is not more expensive than delayed treatment with levodopa.
AB - BACKGROUND: In the Levodopa in EArly Parkinson's disease (LEAP) study, 445 patients were randomized to levodopa/carbidopa 100/25 mg three times per day for 80 weeks (early-start) or placebo for 40 weeks followed by levodopa/carbidopa 100/25 mg three times per day for 40 weeks (delayed-start). OBJECTIVE: This paper reports the results of the economic evaluation performed alongside the LEAP-study. METHODS: Early-start treatment was evaluated versus delayed-start treatment, in which the cost-effectiveness analysis (CEA) and the cost-utility analysis (CUA) were performed from the societal perspective, including health care costs among providers, non-reimbursable out-of-pocket expenses of patients, employer costs of sick leave, and lowered productivity while at work. The outcome measure for the CEA was the extra cost per unit decrease on the Unified Parkinson's Disease Rating Scale 80 weeks after baseline. The outcome measure for the CUA was the extra costs per additional quality adjusted life year (QALY) during follow-up. RESULTS: 212 patients in the early-start and 219 patients in the delayed-start group reported use of health care resources. With savings of € 59 per patient (BCa 95% CI: -829, 788) in the early-start compared to the delayed-start group, societal costs were balanced. The early-start group showed a mean of 1.30 QALYs (BCa 95% CI: 1.26, 1.33) versus 1.30 QALYs (BCa 95% CI: 1.27, 1.33) for the delayed-start group. Because of this negligible difference, incremental cost-effectiveness and cost-utility ratios were not calculated. CONCLUSION: From an economic point of view, this study suggests that early treatment with levodopa is not more expensive than delayed treatment with levodopa.
KW - Parkinson’s disease
KW - cost analysis
KW - levodopa
UR - http://www.scopus.com/inward/record.url?scp=85139885509&partnerID=8YFLogxK
U2 - https://doi.org/10.3233/JPD-223247
DO - https://doi.org/10.3233/JPD-223247
M3 - Article
C2 - 35938258
SN - 1877-7171
VL - 12
SP - 2171
EP - 2178
JO - Journal of Parkinson s disease
JF - Journal of Parkinson s disease
IS - 7
ER -