Cost-effectiveness Analysis of COMT-inhibitors as Adjuvant Treatments to Levodopa in Patients with Advanced Parkinson's Disease

IF 3.2 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2024-09-01 DOI:10.1016/j.clinthera.2024.06.016

Nayoung Kwak MS , Myung-Jun Lee MD , Hye-Young Kang PhD , Hankil Lee PhD

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引用次数: 0

Abstract

Purpose

We aimed to elicit scientific evidence on the cost-effectiveness of two catechol-O-methyltransferase inhibitors (COMT-i) versus no COMT-i in patients with advanced Parkinson's disease.

Methods

A mixed model of the decision tree and a Markov model with three health states by OFF-time level (<25%, ≥25%, and death) was constructed to compare opicapone (OPC), entacapone (ENT), and no COMT-i over a lifetime. A hypothetical cohort of 10,000 patients was created and simulated based on the characteristics of the BIPARK trial subjects.

Findings

Two COMT-i (OPC and ENT) were identified as a cost-effective option compared to no COMT-i. Probabilistic sensitivity analysis showed that over 90% of the simulations proved the robust cost-effectiveness of COMT-i. When the time horizon as the most influential factor decreases to a 5- and 10-year period, COMT-i can be a cost-saving option. Although ENT may be the preferred option over OPC economically because of its lower price, OPC can be acceptable if the drug price is reduced by 17%.

Implications

Add-on treatment with COMT-i in patients with PD receiving levodopa/carbidopa appears to be cost-saving compared with not using COMT-i. In the future, it is necessary to evaluate the economic evaluation of COMT-i based on long-term real-world evidence.

查看原文本刊更多论文

将 COMT 抑制剂作为左旋多巴辅助治疗药物用于晚期帕金森病患者的成本效益分析。

目的：我们旨在为晚期帕金森病患者使用两种儿茶酚-O-甲基转移酶抑制剂（COMT-i）与不使用 COMT-i 的成本效益提供科学证据：方法：采用决策树混合模型和马尔可夫模型，按关机时间水平划分为三种健康状态（结果：两种 COMT-i （OPC-i）和一种 COMT-i （OPC-i））：与不使用 COMT-i 相比，两种 COMT-i（OPC 和 ENT）被确定为具有成本效益的选择。概率敏感性分析表明，90% 以上的模拟证明 COMT-i 具有稳健的成本效益。当影响最大的时间跨度缩短为 5 年和 10 年时，COMT-i 可以成为一种节约成本的选择。虽然 ENT 因其价格较低而在经济上比 OPC 更受青睐，但如果药价降低 17%，OPC 也是可以接受的：与不使用 COMT-i 相比，在接受左旋多巴/卡比多巴治疗的帕金森病患者中加用 COMT-i 似乎更节约成本。今后，有必要根据长期的实际证据对 COMT-i 进行经济评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.