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Pramipexole v. Levodopa as Initial Treatment for Parkinson’s Disease: A Randomized Clinical-Economic Trial

Author

Listed:
  • Katia Noyes
  • Andrew W. Dick

    (Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York.)

  • Robert G. Holloway

    (Department of Community and the Department of Neurology, University of Rochester School of Medicine, Rochester, New York; 601 Elmwood Ave., Box 673, Rochester, NY 14642; telephone: (585) 273-4241robert.holloway@ctcc.rochester.edu.)

Abstract

Purpose . To determine the 2-year incremental cost effectiveness of initial pramipexole treatment compared with initial levodopa treatment in patientswith early Parkinson’s disease (PD) . Methods . 301 subjects with early PD were randomized to either pramipexole or levodopa and followed every 3 months over a 2-year period. Costs were assigned to patient collected health utilization data using a variety of methods. Health state preferences were estimated using the EuroQol . Results . Pramipexole strategy was an estimated $2,138 (SE = $1,182) more expensive than levodopa strategy. The incremental cost-effectiveness of pramipexole compared with levodopa was $106,900/QALY (EQ-5D), compared with pramipexole being dominated by levodopa using the EQVAS . Conclusions .Although considerable uncertainty exists in the 2-year cost-effectiveness of initial pramipexole compared with initial levodopa in the treatment of early PD, our estimates suggest that pramipexole may not be welfare enhancing during the first 2 years of treatment. If initial pramipexole results in long-term improvements in quality of life, its cost-effectiveness will become more favorable.

Suggested Citation

  • Katia Noyes & Andrew W. Dick & Robert G. Holloway, 2004. "Pramipexole v. Levodopa as Initial Treatment for Parkinson’s Disease: A Randomized Clinical-Economic Trial," Medical Decision Making, , vol. 24(5), pages 472-485, October.
    • Handle: RePEc:sae:medema:v:24:y:2004:i:5:p:472-485
    DOI: 10.1177/0272989X04268960
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    References listed on IDEAS

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