OBJECTIVES:  Examine number of hospitalizations, length of stay and costs among patients diagnosed with Parkinson’s Disease initiating therapy with either a dopamine agonist (DA) or Rasagiline. METHODS: This study utilized data from the MarketScan Medicare Supplemental Database from 2/1/2006 through 12/31/2011.  Patients were prescribed Rasagiline or a DA, with first such date identified as index date, were diagnosed with PD in the 3 years post index date (e.g., the post-period), had continuous insurance coverage from 6 months prior (e.g., the pre-period) through the end of the post-period, and were at least 65 years old.  The odds or hospitalization were estimated using logistic regression, while hospital length of stay (LOS) and number of hospitalizations were estimated using negative binomial regressions.  The costs associated with hospitalizations were estimated from a two part multivariate model where the first part estimated the probability of being hospitalized and the second part estimated costs among those hospitalized.   RESULTS: There were 7,230 individuals in the analyses (5,886DA; 1,234 Rasagiline).  The mean age was 76 years and most were male (58.40%), resided in the North Central (33.71%) or Southern (30.14%) regions of the US and were insured via comprehensive (48.42%) or preferred provider organization (36.06%) supplemental insurance.  After controlling for patient characteristics, general health, disability status, comorbid diagnoses, and index prescription characteristics, Rasagiline, compared to DA, was associated with a significantly lower probability of being hospitalized in the post-period (OR=0.755; 95% CI 0.663 – 0.860), significantly fewer hospitalizations (-0.21; P<0.0001) and shorter LOS (-0.38 days; P<0.0001) compared to individuals who initiated on a DA.  Furthermore, total costs associated with hospitalizations were 24% lower among patients who initiated on Rasagiline ($12,327 v $16,525; P<0.0001) compared to initiators on a  DA. CONCLUSIONS: Among patients with PD, initiation with Rasagiline compared to a DA is associated with significantly improved hospitalization outcomes.