Objective: This economic evaluation projects the likely cost-effectiveness of ADS-5102 in comparison to the current standard of best supportive care.

Background: In August, 2017, the FDA approved ADS-5102 (amantadine) extended release capsules (GOCOVRI, Adamas Pharmaceuticals, Inc.) as the first medication for the treatment of dyskinesia in patients with Parkinson’s disease (PD) receiving levodopa-based therapy.

Methods: This economic evaluation was conducted using a cost-utility model with a 10-year base-case patient time horizon from a U.S. payer perspective. The primary economic endpoint was the incremental cost per quality-adjusted life year (QALY) gained. The key clinical parameters were PD home diary-based measures from the EASE LID trials of the average daily reduction from baseline in OFF-time and ON-time with dyskinesias. Natural disease progression was modeled on- and off-treatment. Each outcome was associated with utility values for patient quality of life, which could then be summed to QALYs. The cost of ADS-5102 was included along with a literature-based standard cost of care for PD patients (assumed to decrease for treated patients). Total costs (in US$2017) were summed over time. No adverse events or mortality impacts were modeled.

Results: In the base case, the incremental cost-utility ratio was $98,905 per QALY gained, varying by time horizon from $166,201 (1 year) to $123,261 (5 years). The results are also sensitive to key assumptions about: (1) the utilities of OFF-time, ON-time, and ON-time with dyskinesias; (2) rate of disease progression with and without treatment; (3) adjustment for a placebo effect; and (4) impact of treatment on supportive care costs.

Conclusions: From a clinical perspective, ADS-5102 is a promising new treatment for PD patients with dyskinesia. From an economic perspective, the projected cost-utility ratio appears to be acceptable by commonly-cited thresholds of societal willingness to pay. More data collection on PD patient utilities and disease progression are needed to validate critical assumptions of this model.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-the-potential-cost-effectiveness-of-ads-5102-amantadine-hcl-for-the-treatment-of-dyskinesia-in-parkinsons-disease-patients/