OBJECTIVES: A pharmacoeconomic model is used to estimate the costs and cost-effectiveness of treating Parkinson’s Disease patients with pramipexole in Canada, Germany, and Sweden. METHODS: We developed a cost-effectiveness model that linked Unified Parkinson’s Disease Rating Scale (UPDRS) Part II (ADL) and III (Motor) scores to disease progression, costs, and quality-adjusted life years (QALYs). Data were obtained from clinical trials, literature review, and a survey of 193 patients’ resource use and health utility. Country-specific data on treatment patterns were collected using panels of physician experts in each country. Cost and QALY estimates from the model were used to estimate the incremental cost-effectiveness of pramipexole relative to baseline treatment. Separate analyses were performed for early and advanced Parkinson’s patients, and extensive sensitivity analyses were performed. RESULTS: In Canada and Germany, treatment with pramipexole has higher costs but is more effective than baseline treatment. In Sweden, treatment with pramipexole has lower costs and is more effective than baseline treatment. The incremental cost-effectiveness ratios for early patients in Canada, Germany, and Sweden are $CDN 28,097, DM 26,780, and - SEK 41,161, respectively, in 1997 currency. For advanced patients, the corresponding ratios are $CDN 25,090, DM 49,168, and - SEK 27,386. These ratios are lower than the cost-effectiveness ratios of many widely used medical treatments. CONCLUSIONS: Subject to the inherent limitations of modeling chronic disease progression and subsequent health utility and costs, the results indicate that pramipexole is a cost-effective treatment for early and advanced Parkinson’s disease patients in Canada, Germany, and Sweden.