OBJECTIVES: A model assessing sequential olfactory testing and dopamine transporter (DAT) imaging for screening pre-motor Parkinson’s Disease (PD) was adapted to a European setting with German cost and health utility data.   METHODS: PD Associated Risk Study (PARS) data were used to parameterize screening efficacy.  Screening strategies in persons 1) in a general population, 2) with a relative with PD, 3) with LRRK2+ genotype, and 4) with REM sleep disorder were evaluated.  PD prevalence per 100 at screening was 0.5, 2, 10 and 20 for these groups.  Olfactory test and DAT costs were €11 and €1500, respectively.  We assumed disease modifying (DM) therapy was available that slowed disease progression by 20% at a cost of €30,000.  Economic value was measured in net monetary benefits (NMB), valuing a quality-adjusted life-year at €50,000. RESULTS: Screening sensitivity and specificity were 64% and 99%, respectively.  13.4% had positive results on the olfactory test and also took the DAT.  NMB for the four groups was €-169, €269, €2,603, and €5,521, indicating that screening has positive economic value in persons with a close relative with PD, persons with LRRK2+ genotype, and persons with REM sleep disorder.  Screening value was positively correlated with rate of progression from preclinical to clinical PD, efficacy of DM therapy, and QALY monetization.  Screening value was negatively correlated with costs of false positives, screening cost, age at onset, Hoehn and Yahr stage at which the unscreened diagnosis is made, and cost of DM therapy. CONCLUSIONS: Screening for early PD may be a cost-effective strategy for certain risk groups.