The Cost-Effectiveness of Opicapone Versus Entacapone as Adjuvant Therapy for Levodopa-Treated Individuals With Parkinson's Disease Experiencing End-of-Dose Motor Fluctuations.
Glynn Harrison-Jones, William Green, Jamie Bainbridge
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引用次数: 0
Abstract
Background: In levodopa-treated individuals with Parkinson's disease (PD) and end-of-dose motor fluctuations, the BIPARK-I randomized controlled trial (RCT) demonstrated that opicapone is noninferior to entacapone in reducing OFF-time. Furthermore, the BIPARK-II RCT demonstrated that opicapone is well tolerated and significantly reduces OFF-time compared with placebo. This study developed a cost-effectiveness model (CEM) of opicapone compared with entacapone from the perspective of the English National Health Service (NHS) and personal social services (PSS). Methods: The CEM used a Markov model with three health states, including "<25% OFF-time," "≥25% OFF-time," and "dead," as individuals spending less than 25% of their awake time experiencing OFF-time have previously been shown to have a significantly improved health-related quality of life and to accumulate fewer healthcare costs. The CEM had a 25-year time horizon, expressed costs as 2021/22 Great British Pounds (GBPs), and health outcomes as quality-adjusted life years (QALYs). Both costs and health outcomes were discounted at 3.5% annually, and a cost-effectiveness threshold of £20,000 per QALY was used. Probabilistic sensitivity analysis (PSA) considered parameter uncertainty. Results: The deterministic base case indicates that an individual treated with opicapone accrues fewer costs and more QALYs compared with each entacapone comparator and, therefore, is considered cost-effective. The PSA indicates that the probability that opicapone is cost-effective ranges from 87.2% to 98.0%, depending on the choice of entacapone comparator. Conclusions: Opicapone is cost-effective when compared with entacapone for levodopa-treated PD patients experiencing end-of-dose motor fluctuations. Trial Registration: ClinicalTrials.gov identifier: NCT01568073.
期刊介绍:
Parkinson’s Disease is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.