OBJECTIVE: 25% to 30% of patients with Parkinson’s disease treated with levodopa present motor complications after three years. The health-care consumption by patients with these symptoms is roughly twice as high as the costs for patients without them. A clinical trial comparing cabergoline (with the possibility if adding levodopa if needed) to levodopa has shown that the use of cabergoline delays the onset of motor complications. The purpose of this study is to compare the cost effectiveness of the two treatment strategies in a Swedish setting. METHODS: A Markov model was constructed with states based on the Hoehn and Yahr (HY) stages with an additional stage for patients with complications. Transition probabilities between the HY stages were calculated from the clinical trial data using ordered probit regression, while the probability of developing complications was based on the frequency of this event at each time point in the trial. Direct costs were derived from a Swedish observational study. Years-of-complications-avoided was used as the measure of effectiveness in this analysis. RESULTS: The incremental cost-effectiveness ratio for cabergoline was 4000 USD per year of motor complications avoided. Inclusion of indirect costs would influence the results in younger patients. The literature suggests that the costs of indirect care would decrease the cost-effectiveness ratio, so that the number reported here may represent an overestimate of the total cost of preventing motor complications. CONCLUSION: Based on our data, Cabergoline was found to represent a cost-effective means for reducing the impact of motor dysfunction if the willingness to pay exceeds 4000 USD per year of motor complications avoided. Population Cost & Health Issues