Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease
Identifieur interne : 000191 ( PascalFrancis/Curation ); précédent : 000190; suivant : 000192Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease
Auteurs : Michael Iskedjian [Canada] ; Thomas R. Einarson [Canada]Source :
- PharmacoEconomics : (Auckland) [ 1170-7690 ] ; 2003.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
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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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease</title><author><name sortKey="Iskedjian, Michael" sort="Iskedjian, Michael" uniqKey="Iskedjian M" first="Michael" last="Iskedjian">Michael Iskedjian</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Pharmldeas Research & Consulting Inc.</s1><s2>Oakville, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author><author><name sortKey="Einarson, Thomas R" sort="Einarson, Thomas R" uniqKey="Einarson T" first="Thomas R." last="Einarson">Thomas R. Einarson</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Pharmldeas Research & Consulting Inc.</s1><s2>Oakville, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Faculty of Pharmacy, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">03-0206081</idno><date when="2003">2003</date><idno type="stanalyst">PASCAL 03-0206081 INIST</idno><idno type="RBID">Pascal:03-0206081</idno><idno type="wicri:Area/PascalFrancis/Corpus">000B32</idno><idno type="wicri:Area/PascalFrancis/Curation">000191</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease</title><author><name sortKey="Iskedjian, Michael" sort="Iskedjian, Michael" uniqKey="Iskedjian M" first="Michael" last="Iskedjian">Michael Iskedjian</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Pharmldeas Research & Consulting Inc.</s1><s2>Oakville, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author><author><name sortKey="Einarson, Thomas R" sort="Einarson, Thomas R" uniqKey="Einarson T" first="Thomas R." last="Einarson">Thomas R. Einarson</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Pharmldeas Research & Consulting Inc.</s1><s2>Oakville, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Faculty of Pharmacy, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author></analytic><series><title level="j" type="main">PharmacoEconomics : (Auckland)</title><title level="j" type="abbreviated">PharmacoEconomics : (Auckl. )</title><idno type="ISSN">1170-7690</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">PharmacoEconomics : (Auckland)</title><title level="j" type="abbreviated">PharmacoEconomics : (Auckl. )</title><idno type="ISSN">1170-7690</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Agonist</term><term>Antiparkinson agent</term><term>Chemotherapy</term><term>Comparative study</term><term>Cost analysis</term><term>Cost efficiency analysis</term><term>D2 Dopamine receptor</term><term>Dopamine agonist</term><term>Health economy</term><term>Human</term><term>Levodopa</term><term>Parkinson disease</term><term>Ropinirole</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Ropinirole</term><term>Lévodopa</term><term>Antiparkinsonien</term><term>Parkinson maladie</term><term>Chimiothérapie</term><term>Traitement</term><term>Homme</term><term>Economie santé</term><term>Analyse coût</term><term>Etude comparative</term><term>Agoniste</term><term>Récepteur dopaminergique D2</term><term>Stimulant dopaminergique</term><term>Analyse coût efficacité</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1170-7690</s0></fA01><fA03 i2="1"><s0>PharmacoEconomics : (Auckl. )</s0></fA03><fA05><s2>21</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>ISKEDJIAN (Michael)</s1></fA11><fA11 i1="02" i2="1"><s1>EINARSON (Thomas R.)</s1></fA11><fA14 i1="01"><s1>Pharmldeas Research & Consulting Inc.</s1><s2>Oakville, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></fA14><fA14 i1="02"><s1>Faculty of Pharmacy, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></fA14><fA20><s1>115-127</s1></fA20><fA21><s1>2003</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>26124</s2><s5>354000104169990040</s5></fA43><fA44><s0>0000</s0><s1>© 2003 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>25 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>03-0206081</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>PharmacoEconomics : (Auckland)</s0></fA64><fA66 i1="01"><s0>NZL</s0></fA66><fC01 i1="01" l="ENG"><s0>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. 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