Session Information
Date: Sunday, October 7, 2018
Session Title: Other
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
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.
To cite this abstract in AMA style:
R. Pahwa, L. Garrison, M. Zimmerman, R. Johnson, J. Nguyen, M. Li, R. Patni. Assessing the potential cost-effectiveness of ads-5102 (Amantadine HCl) for the treatment of dyskinesia in Parkinson’s disease patients [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/assessing-the-potential-cost-effectiveness-of-ads-5102-amantadine-hcl-for-the-treatment-of-dyskinesia-in-parkinsons-disease-patients/. Accessed September 7, 2024.« 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/