OBJECTIVES: Parkinson’s disease(PD) is the second common neuro-degenerative disease in US older adults. Until recently, Levodopa was the only treatment for PD. Although, Ropinirole is approved by FDA for PD, there are no cost-effectiveness studies comparing these treatments. The objective of our study is to perform cost-effectiveness analysis comparing Ropinirole and the combination therapy of Levodopa/Carbidopa in the treatment of PD. METHODS: A cost-effectiveness analysis was performed from the patient’s perspective to compare Ropinirole and Levodopa/Carbidopa treatment in PD patients using a decision tree model as a pragmatic tool to derive comparative information on the costs and effectiveness of these two strategies over a 5-year period. A predictive model was developed to capture utilization, such as medication(drug) costs, physician costs, caregiver time, and productivity loss. Clinical information was derived from a comparative effectiveness study. All direct and indirect costs were obtained from pharmacists, published literature, and medical practitioners. Effectiveness was measured in terms of quality adjusted life years(QALY) reported in literature.  Costs were adjusted to 2009 U.S. dollars. One way and two way sensitivity analyses with 25% change in cost and 20% change in QALY values were performed and incremental cost effectiveness ratio(ICER) was calculated. RESULTS: The Ropinirole therapy resulted in a gain of 2.82 QALY’s at a cost of $107,062 compared to Levodpo/Carbidopa combination therapy which resulted in a gain of 2.35 QALY’s at a cost of $102,423 at the end of 5 years. The expected cost per QALY was $37,965 for Ropinirole while that of Levodopa/Carbidopa combination was $43,584. One way and two way analyses were consistent, validating the results. ICER was found to be $9,870 per QALY for switching from Ropinirole to Levodopa/Carbidopa therapy. CONCLUSIONS: Our cost-effectiveness analysis indicates that Ropinirole is a better option as compared to Levodopa/Carbidopa for treatment of patient suffering from PD.