PND30 - Economic Evaluation of the Treatment Compliance in Patients with Parkinson’s Disease Received Different Preparations of Levodopa

Abstract

To assess the cost-effectiveness of two conventional combinations of levodopa and decarboxylase inhibitors (benserazide or carbidopa) in the treatment of Russian patients with Parkinson’s disease. The pharmacoeconomic model was developed based on the data from multicentre randomized controlled triple-blind trial (H. Pakkenberg et al., 1976) on the efficacy and tolerance of levodopa+benserazide and levodopa+carbidopa in the treatment of patients with Parkinson’s disease previously not treated with levodopa. A six-month time horizon was adopted in the model. The cost analysis included costs of the original preparation of levodopa+benserazide and costs of the available in Russia generic preparations of levodopa+carbidopa and considered on-demand antiemetic treatment with domperidone to reduce the incidence of gastrointestinal side effects of levodopa. The efficacy of treatment was defined as proportion of patients with full compliance to the treatment protocol and proportion of patients without side effects (nausea and vomiting, hyperkinesia). Treatment with levodopa+benserazide was associated with significantly lower incidence of patient non-compliance (43% as compared to 76% in the levodopa+carbidopa group). Less patients in levodopa+benserazide group experienced side effects of levodopa. The expenses for antiemetic treatment was 8.7-fold lower in patients treated with levodopa+benserazide as compared to those received levodopa+carbidopa. Total costs in levodopa+benserazide group were 912,264.90 RUB per 100 patients and varied from 682,154.60 RUB to 1,255,226.00 RUB in levodopa+carbidopa groups. The cost-effectiveness ratios (CERs) were 15,692.02 RUB and 21,988.11 – 45,866.08 RUB per one patient with full compliance to the protocol in the levodopa+benserazide and levodopa+carbidopa groups, respectively. The similar results were observed for the CERs estimated per one patient without side effects of levodopa. The present study has demonstrated that administration of levodopa+benserazide is an economically effective strategy in the treatment of Russian patients with Parkinson’s disease.