Cost-Effectiveness of Carbidopa-Levodopa Enteral Suspension for Advanced Parkinson's Disease in the United States

Background: Carbidopa/levodopa enteral suspension (CLES) is indicated for the treatment of advanced Parkinson's disease (aPD) with severe motor fluctuations.ObjectiveTo determine the cost, quality-adjusted life years (QALY), and cost-effectiveness of CLES compared to the standard-of-care (SoC) for aPD patients in the United States (US), using real-world data.Methods: A published Markov model, comprising of 25 health states and a death state, (defined by a combination of the Hoehn and Yahr scale and waking time spent in OFF-time) was adapted to estimate the benefits for CLES versus oral SoC over a patient's lifetime in the US healthcare setting. Clinical inputs were based on a clinical trial and a registry study; utility inputs were sourced from the Adelphi-Disease Specific Programmes.Results: CLES compared to SoC was associated with incremental costs ($1,031,791 vs. $1,025,180) and QALY gain (4.61 vs. 3.76), resulting in an incremental cost-effectiveness ratio of $7711/QALY.Conclusion: CLES is a cost-effective treatment for aPD patients with medication resistant motor fluctuations. (c) 2023 AbbVie, Inc and The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Automated summary

This study aims to compare the cost, quality-adjusted life years (QALY), and cost-effectiveness of Carbidopa/levodopa enteral suspension (CLES) and the standard-of-care (SoC) for Parkinson's disease (PD) patients in the US. The results showed that although CLES is associated with incremental costs, it provides greater QALY gain, making it a cost-effective treatment option for PD patients with medication-resistant motor fluctuations.