OBJECTIVES: To perform cost-utility analysis and calculated Quality Adjusted Life Years (QALY) for dopamine agonists such as Pramipexole and Piribedil on patients with early Parkinson's Disease (PD). METHODS: Basic treatment of 40 early PD patients included amantadine and anticholinergics at least within one year. Pramipexole (mean dose: 2.4 ± 1.1 mg) was added to basic treatment of 18 patients within one year, and Piribedil (mean dose: 168.2 ± 24.6 mg) was added to treatment of 22 patients within one year as well. To evaluate quality of life, we included the 39-item Parkinson's Disease Questionnaire (PDQ-39) at baseline, one-year after basic treatment and one-year after treatment by dopamine agonists. Utility was measured by percentage reduction of PDQ-39 and changes of summary index. We carried out the cost-utility analysis and calculated QALY for both agonists. Only direct costs were estimated. RESULTS: Quality of life, characterized by summary index of PDQ-39, changed compared with basic treatment from 0.516 (range 0-1) up to 0.717 for Pramipexole group (mean percent PDQ-39 score reduction was 20.1%). For the Piribedil group, summary index of PDQ-39 changed compared with basic treatment from 0.618 up to 0.725 (mean percent PDQ-39 score reduction was 10.7%). For the Pramipexole group, mean cost of basic treatment was $13.42 compared to $1544.29 of Pramipexole treatment. For the Piribedil group, mean cost of basic treatment was $8.16 compared to $506.96 of Piribedil treatment. Cost-utility for the Pramipexole group was $76.83 per 1% PDQ-39 score reduction and 47.38$ per 1% PDQ-39 score reduction for the Piribedil group. For early PD patients treated by Pramipexole, QALY costs $1263.35 and $383.56 for patients treated with Piribedil QALY. CONCLUSIONS: For early PD patients, use of Piribedil is more cost-utility than use of Pramipexole. QALY for Piribedil treatment costs much less than Pramipexol treatment.