Objective:

Conduct a comparative pharmacoeconomic analysis of the use of  subcutaneous apomorphine infusion pump (SAIP),   continuous levodopa/carbidopa duodenal infusión (LDI) and deep brain stimulation (DBS).

Background:

When oral or transdermal drug therapy in Parkinson’s disease becomes less effective, there are three therapies using assisted devices that can reduce motor and non-motor complications: SAIP, LDI and DBS.

Methods:

After making an active search, information on life years gained (LYG) and quality adjusted life years (QALY) according to Hoehn and Yahr scale was obtained, as well as data on costs and resource use for each of the alternatives. The perspective of the analysis was the National Health System and the time horizon was 5 years for costs and patient´s lifetime for utilities, while discount rate was 3.5%. Outcome measures used were  LYG and QALYs, and incremental cost/utility ratio for comparison.

Results:   Cost/utility ratio was obtained for each option: € 31,956 / QALY for DBS; 38,249 € / QALY for SAIP and 75,206 € / QALY for LDI.

Conclusions:

Our results allow us to add information about effectiveness of different treatments, as these are presented in gain of years lived in full health (QALY).  Data obtained contribute to decision making that determine planning and management of each case, without forgetting patient and neurologist preferences, as well as budgetary limitations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pharmaeconomic-study-of-the-treatment-of-advanced-parkinsons-disease/