OBJECTIVES: This study aims to evaluate the cost-utility of rasagiline as adjunctive therapy in Levodopa-treated Parkinson’s disease (PD) patients with motor fluctuations from the China societal perspective.

METHODS: A published cost-utility Markov model with three health states (≤25% off-time/day, >25% off-time/day and dead) was adapted to the China context. The time horizon of the simulation was two years with a cycle length of 4-month. Transition probabilities and initial distribution of patients were obtained from randomized clinical trial data; utilities were from a preference measurement study; resource use and costs were from an extensive survey conducted among fifty PD specialists/neurologists spread across ten cities of China. The direct and indirect costs were considered. The outcomes were quality-adjusted life years (QALYs), caregiver hours needed/day, and proportion of patients receiving help from paid and unpaid caregivers. Both clinical outcomes and costs were discounted at a 5% annual rate.

RESULTS: At the end of two years, rasagiline as adjunctive therapy to levodopa resulted in higher QALYs than levodopa alone (1.03 vs. 0.90), more patients with ≤25% off-time (41% vs. 22%) and less patients with >25% off-time (47% vs. 66%), lower caregiving hours/day (5.99 vs. 7.15), a lower proportion of patients receiving help from paid caregivers (18% vs. 20%) and unpaid caregivers (48% vs. 51%). Furthermore, lower total costs were found in the strategy of rasagiline as adjunctive therapy to levodopa compared to levodopa alone (177,919 RMB vs. 190,933 RMB). However, rasagiline as adjunctive therapy to levodopa was associated with higher direct costs (66,570 RMB vs. 52,512 RMB).

CONCLUSIONS: Rasagiline as adjunctive therapy to levodopa was shown to be a dominant treatment option as associated with more QALYs gained and lower overall costs, compared to levodopa alone from the societal perspective for PD in China.