Cost-effectiveness of opicapone and entacapone in reducing OFF-time in Parkinson's disease patients treated with levodopa/carbidopa. (1st January 2021)

• Record Type: Journal Article
• Authors: Hansen, Ryan N.; Suh, Kangho; Serbin, Michael; Yonan, Chuck; Sullivan, Sean D.
• Is Part Of: Journal of medical economics. Volume 24:Number 1(2021)
• Page Start: 563
• Page End: 569
• Publication Date: 2021-01-01
• Subjects: Parkinson's disease -- OFF-time -- COMT inhibitors -- opicapone -- entacapone -- cost effectiveness; I11 -- I13; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2021.1916750
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Aims: To assess from a US payer perspective the relative cost-effectiveness of the catechol- O -methyltransferase inhibitors opicapone and entacapone when used adjunctively to levodopa/carbidopa (LD/CD) in patients with Parkinson's disease (PD), based on the drugs' effects to reduce absolute OFF-time hours in PD patients. Materials and Methods: A Markov model was created to estimate cost-effectiveness of adjunctive opicapone treatment compared with adjunctive entacapone treatment in a synthetic cohort of 1, 000 patients with PD taking LD/CD. Clinical inputs were derived from clinical trials, published literature, and expert opinion. Cost data (in 2018 US dollars) were obtained from the Centers for Medicare & Medicaid Services, the Kaiser Family Foundation, and Analy$ource. Cost-effectiveness outcomes included incremental cost per OFF-time hours avoided, cost per life year gained, and cost per quality-adjusted life year (QALY) gained. Outcomes were projected over a 25-year lifetime horizon and discounted at 3% annually. Results: Opicapone treatment was associated with an average of 1, 187 fewer OFF-time hours per patient and an increase of 0.07 QALYs compared with entacapone. Total lifetime costs for opicapone were $3, 100 higher than entacapone, resulting in an incremental cost-effectiveness ratio of $46, 900 per QALY. One-way sensitivity analyses showed the model was most sensitive to mean OFF-time hours associated with opicapone and entacapone. Probabilistic sensitivity analysis suggested a 60–65% probability that opicapone was cost-effective relative to entacapone at any willingness-to-pay threshold ≥$5, 000. Limitations: There exists a single head-to-head clinical trial comparing the effectiveness of opicapone with entacapone, thus the clinical inputs regarding relative treatment effect of the drugs to reduce OFF-time hours in PD patients receiving LD/CD were derived from that single non-inferiority trial. Conclusions: Add-on treatment with opicapone in PD patients receiving LD/CD appeared to be cost-effective compared with entacapone.