Abstract：
OBJECTIVE: 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.
RESULTS: 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%.
CONCLUSIONS: 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.
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.
RESULTS: 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%.
CONCLUSIONS: 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.
摘要：
目的：我们的目的是获得关于两种儿茶酚-O-甲基转移酶抑制剂（COMT-i）与无COMT-i治疗晚期帕金森病患者的成本效益的科学证据。
方法：决策树的混合模型和按OFF时间水平具有三种健康状态的马尔可夫模型（<25％，≥25%,和死亡)是为了比较opicapone(OPC)，entacapone(ENT),一辈子都没有COMT-i。根据BIPARK试验受试者的特征，创建并模拟了一个由10,000名患者组成的假设队列。
结果：与没有COMT-i相比，两个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，超过90％的模拟证明了COMT-i的强大成本效益。当作为最有影响因素的时间范围减少到5年和10年时，COMT-i可以是节省成本的选择。尽管ENT在经济上可能是OPC的首选，因为它的价格较低，如果药品价格降低17%，OPC是可以接受的。
结论：与不使用COMT-i相比，接受左旋多巴/卡比多巴的PD患者使用COMT-i的附加治疗似乎可以节省成本。在未来,有必要基于长期的现实证据来评估COMT-i的经济评价。
方法：决策树的混合模型和按OFF时间水平具有三种健康状态的马尔可夫模型（<25％，≥25%,和死亡)是为了比较opicapone(OPC)，entacapone(ENT),一辈子都没有COMT-i。根据BIPARK试验受试者的特征，创建并模拟了一个由10,000名患者组成的假设队列。
结果：与没有COMT-i相比，两个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，超过90％的模拟证明了COMT-i的强大成本效益。当作为最有影响因素的时间范围减少到5年和10年时，COMT-i可以是节省成本的选择。尽管ENT在经济上可能是OPC的首选，因为它的价格较低，如果药品价格降低17%，OPC是可以接受的。
结论：与不使用COMT-i相比，接受左旋多巴/卡比多巴的PD患者使用COMT-i的附加治疗似乎可以节省成本。在未来,有必要基于长期的现实证据来评估COMT-i的经济评价。
