OBJECTIVE: Assess the cost-utility of rasagiline, entacapone and standard care (levodopa) in Parkinson's disease (PD) patients with motor fluctuations in Finland. METHODS: A 2-year probabilistic Markov model with 3 health states: ≤25% off-time/day', ‘>25% off-time/day' and ‘dead' was used. Model inputs included transition probabilities from randomised clinical trials, utilities from a preference measurement study and costs and resources from a Finnish cost-of-illness study. Effectiveness measures were Quality Adjusted Life Years (QALYs) and number of months spent with ≤25% off-time/day. The primary analysis was performed from the societal perspective. Extensive sensitivity and subgroup analyses on severe patients were performed. A parity price was assumed for rasagiline and entacapone based on WHO-DDD. RESULTS: Over 2 years, rasagiline appeared to show both greater effectiveness and cost reductions compared with standard care (0.38 additional QALYs, over 55% additional time spent with ≤25% off-time/day and €900 savings (95% CI: [-€3400; €1090]) per treated patient. Rasagiline and entacapone yielded similar effectiveness and costs. A trend in favour of rasagiline was observed in the severe patient subgroup (approximately €660 total cost savings/patient). Sensitivity analyses confirmed robustness of the results vs. standard care. Results vs. entacapone were sensitive to changes in transition probabilities and drug prices. CONCLUSION: This economic model supports the use of rasagiline as a cost-effective treatment compared with levodopa alone and combined with entacapone in PD patients with motor fluctuations in Finland. Further improvements of the model should be applied to different settings to confirm these results.