OBJECTIVES: This study aims to assess the clinical and economic impact of levodopa/carbidopa/entacapone in the management of Parkinson's disease (PD) in the context of the Kazakhstani healthcare system.

METHODS: Our analysis incorporated annual direct costs per patient in the management of PD in adult patients comparing LCE with a fixed-dose combination of levodopa/carbidopa (LC). We conducted a comprehensive economic evaluation focusing on the cost-effectiveness and one-way sensitivity analysis up to 50%. The primary endpoint measure utilized the change observed in QALY, and secondary the Unified Parkinson's Disease Rating Scale (UPDRS).

RESULTS: The findings of the cost-effectiveness analysis unveiled a compelling cost-effectiveness advantage of a fixed combination regimen of LCE over of LC, in the PD management. LCE resulted in a better ratio of the main cost-effectiveness ratio (CER) parameters and a positive incremental cost-effectiveness ratio (ICER), regardless of which effectiveness criterion was applied. For the QALY, the CER was USD1096 versus USD408 and the ICER was USD9175; for the UPDRS, the CER was USD4331 versus USD6332 and the ICER was USD3717. Obtaining the ICER value is significantly less than the conditional readiness threshold for Kazakhstan, estimated as a 3 GDP (USD34710). Our findings are confirmed with sensitivity analysis.

CONCLUSIONS: Recent findings have unveiled compelling evidence regarding the efficacy and safety profile of the fixed-dose combination of LCE among individuals diagnosed with PD. These pivotal insights have substantiated its incorporation into numerous global clinical guidelines. Moreover, the favorable pharmacoeconomic attributes of LCE warrant its endorsement for the management of PD in Kazakhstan.