OBJECTIVES: To identify the budget impact of dopamine agonists: piribedil (Pronoran) and ropinirol (Requip) in Parkinson disease based on alternative reimbursement scenarios in Poland. METHODS: Calculations were based on Polish data on dopamine agonists sales for period 01.2006-03.2007 (IMS Poland). An assumption about 50% of patients with newly diagnosed Parkinson disease treatment with dopamine agonists was established. Estimates of the reimbursement costs when treatment of the eligible population were done taking into consideration three different scenarios: 1) Requip is reimbursed (6.68PLN per DDD) but no public coverage for Pronoran; 2) both drugs are reimbursed but reimbursement for Requip (4.59PLN per DDD) is limited by Pronoran (3.67PLN per DDD); and 3) both drugs are reimbursed and reimbursement level per DDD is the same in case of Pronoran and Requip (3.67PLN per DDD). Net budgetary effects for public payer were calculated when scenario: 2 or 3 was compared with scenario 1. All calculations were made for 2006 (1€ = 3.8PLN). RESULTS: Taking into account annual sales of the drugs and assumed that scenario 1 is replaced by scenario 2 it occurred that total savings for public payer in Poland were: 3530000PLN-10611000PLN (€ 923000-2792000) per year. In case of Pronoran and Requip were reimbursed and both had the same reimbursement level (3.67PLN per DDD) total savings for public payer in Poland would be: 4174000PLN-12522000PLN (€ 1098000-3295000) annually. CONCLUSION: Pronoran reimbursement in Poland lead to significant savings for public payer. The savings are especially high in case of the same reimbursement level per DDD for Pronoran and Requip.