La maladie de Parkinson au Canada (serveur d'exploration)

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Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease

Identifieur interne : 002F43 ( Main/Curation ); précédent : 002F42; suivant : 002F44

Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease

Auteurs : Michael Iskedjian [Canada] ; Thomas R. Einarson [Canada]

Source :

RBID : Pascal:03-0206081

Descripteurs français

English descriptors

Abstract

Background: Not all patients with Parkinson's disease (PD) respond to levodopa and others develop dyskinesias. Ropinirole, a dopamine agonist, is associated with fewer dyskinesias than levodopa. Objective: To examine the economic impact of reducing dyskinesias using ropinirole instead of levodopa plus benserazide in PD was examined. The research question addressed was: is the added cost of ropinirole offset by savings due to avoided cases of dyskinesia? Methods: A cost-minimisation analysis was performed from both the societal and Ministry of Health (MoH) of Ontario, Canada perspectives, using 5-year data from a study of dyskinesia outcomes comparing ropinirole with levodopa plus benserazide. A predictive model was developed to capture resource utilisation over 5 years, such as medication costs, medical consultations, hospital admissions, nursing home admissions, caregiver time and productivity loss. The model was based on a previously reported clinical trial which determined dyskinesia rates to be 20% for ropinirole and 45% for levodopa. Standard costing lists were used, and costs were discounted at various rates. Constant 1999 Canadian dollars ($Can) were applied, and no increases were assumed over the time horizon of the analysis. A multivariate sensitivity analysis with changes in key parameters was also performed. Results: From a societal perspective, ropinirole was cost saving. From the MoH perspective, the analysis yielded an incremental expected daily cost/patient of $Can4.41 for substituting levodopa plus benserazide with ropinirole. Ropinirole resulted in daily savings/patient of $Can0.17 in non-drug healthcare costs. In the sensitivity analysis, the direction of results did not change despite changes of 15 to 20% in key parameters, suggesting robustness of the model. Conclusions: From the societal perspective, in comparison with levodopa plus benserazide, the added cost of ropinirole is offset by savings due to avoided cases of dyskinesia.

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Pascal:03-0206081

Le document en format XML

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</author>
<author>
<name sortKey="Einarson, Thomas R" sort="Einarson, Thomas R" uniqKey="Einarson T" first="Thomas R" last="Einarson">Thomas R. Einarson</name>
</author>
</analytic>
<series>
<title level="j">PharmacoEconomics</title>
<idno type="ISSN">1170-7690</idno>
<imprint>
<date when="2003" type="published">2003</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Adult</term>
<term>Antiparkinson Agents (economics)</term>
<term>Antiparkinson Agents (therapeutic use)</term>
<term>Benserazide (economics)</term>
<term>Benserazide (therapeutic use)</term>
<term>Canada</term>
<term>Caregivers (economics)</term>
<term>Cost Savings</term>
<term>Dopamine Agonists (economics)</term>
<term>Dopamine Agonists (therapeutic use)</term>
<term>Drug Costs</term>
<term>Health Care Costs</term>
<term>Humans</term>
<term>Indoles (economics)</term>
<term>Indoles (therapeutic use)</term>
<term>Levodopa (economics)</term>
<term>Levodopa (therapeutic use)</term>
<term>Middle Aged</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (economics)</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en">
<term>Antiparkinson Agents</term>
<term>Benserazide</term>
<term>Dopamine Agonists</term>
<term>Indoles</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>Antiparkinson Agents</term>
<term>Benserazide</term>
<term>Dopamine Agonists</term>
<term>Indoles</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" type="geographic" xml:lang="en">
<term>Canada</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en">
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="economics" xml:lang="en">
<term>Caregivers</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adult</term>
<term>Cost Savings</term>
<term>Drug Costs</term>
<term>Health Care Costs</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr">
<term>Canada</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Not all patients with Parkinson's disease (PD) respond to levodopa and others develop dyskinesias. Ropinirole, a dopamine agonist, is associated with fewer dyskinesias than levodopa.</div>
</front>
</TEI>
</PubMed>
</double>
</record>

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