{Reference Type}: Journal Article
{Title}: Cost-Effectiveness Analysis of COMT-Inhibitors as Adjuvant Treatments to Levodopa in Patients with Advanced Parkinson's Disease.
{Author}: Kwak N;Kang HY;Lee MJ;Lee H;
{Journal}: Clin Ther
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 31
{Factor}: 3.637
{DOI}: 10.1016/j.clinthera.2024.06.016
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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%.<BR><B>CONCLUSIONS: </B>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.