eprintid: 10146024
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/14/60/24
datestamp: 2022-03-30 09:54:53
lastmod: 2022-03-30 09:54:53
status_changed: 2022-03-30 09:54:53
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Chaudhuri, KR
creators_name: Pickard, AS
creators_name: Alobaidi, A
creators_name: Jalundhwala, YJ
creators_name: Kandukuri, PL
creators_name: Bao, Y
creators_name: Sus, J
creators_name: Jones, G
creators_name: Ridley, C
creators_name: Oddsdottir, J
creators_name: Najle-Rahim, S
creators_name: Madin-Warburton, M
creators_name: Xu, W
creators_name: Schrag, A
title: The Cost Effectiveness of Levodopa-Carbidopa Intestinal Gel in the Treatment of Advanced Parkinson’s Disease in England
ispublished: inpress
divisions: C07
divisions: F84
divisions: B02
divisions: UCL
divisions: D07
note: This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
abstract: Background: Parkinson’s disease is a progressive neurodegenerative disease, which significantly impacts patients’ quality of life and is associated with high treatment and direct healthcare costs. In England, levodopa/carbidopa intestinal gel (LCIG) is indicated for the treatment of levodopa-responsive advanced Parkinson’s disease with troublesome motor fluctuations when available combinations of medicinal products are unsatisfactory. Objective: We aimed to determine the cost effectiveness of LCIG compared to the standard of care for patients with advanced Parkinson’s disease in England, using real-world data. Methods: A Markov model was adapted from previous published studies, using the perspective of the English National Health System and Personal and Social Services to evaluate the cost effectiveness of LCIG compared to standard of care in patients with advanced Parkinson’s disease over a 20-year time horizon. The model comprised 25 health states, defined by a combination of the Hoehn and Yahr scale, and waking time spent in OFF-time. The base case considered an initial cohort of patients with an Hoehn and Yahr score of ≥ 3, and > 4 h OFF-time. Standard of care comprised standard oral therapies, and a proportion of patients were assumed to be treated with subcutaneous apomorphine infusion or injection in addition to oral therapies. Efficacy inputs were based on LCIG clinical trials where possible. Resource use and utility values were based on results of a large-scale observational study, and costs were derived from the latest published UK data, valued at 2017 prices. The EuroQol five-dimensions-3-level (EQ-5D-3L) instrument was used to measure utilities. Costs and quality-adjusted life-years were discounted at 3.5%. Both deterministic and probabilistic sensitivity analyses were conducted. Results: Total costs and quality-adjusted life-years gained for LCIG vs standard of care were £586,832 vs £554,022, and 2.82 vs 1.43, respectively. The incremental cost-effectiveness ratio for LCIG compared to standard of care was £23,649/quality-adjusted life-year. Results were sensitive to the healthcare resource utilisation based on real-world data, and long-term efficacy of LCIG. Conclusions: The base-case incremental cost-effectiveness ratio was estimated to be within the acceptable thresholds for cost effectiveness considered for England.
date: 2022-03-21
date_type: published
publisher: Springer Science and Business Media LLC
official_url: https://doi.org/10.1007/s40273-022-01132-y
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1946513
doi: 10.1007/s40273-022-01132-y
lyricists_name: Schrag, Anette
lyricists_id: AESCH71
actors_name: Sayed, Imran
actors_id: ISAYE60
actors_role: owner
full_text_status: public
publication: PharmacoEconomics
citation:        Chaudhuri, KR;    Pickard, AS;    Alobaidi, A;    Jalundhwala, YJ;    Kandukuri, PL;    Bao, Y;    Sus, J;                             ... Schrag, A; + view all <#>        Chaudhuri, KR;  Pickard, AS;  Alobaidi, A;  Jalundhwala, YJ;  Kandukuri, PL;  Bao, Y;  Sus, J;  Jones, G;  Ridley, C;  Oddsdottir, J;  Najle-Rahim, S;  Madin-Warburton, M;  Xu, W;  Schrag, A;   - view fewer <#>    (2022)    The Cost Effectiveness of Levodopa-Carbidopa Intestinal Gel in the Treatment of Advanced Parkinson’s Disease in England.                   PharmacoEconomics        10.1007/s40273-022-01132-y <https://doi.org/10.1007/s40273-022-01132-y>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10146024/3/Sayed_s40273-022-01132-y.pdf