Cabergoline versus levodopa monotherapy: a decision analysis

Mov Disord. 2003 Aug;18(8):898-905. doi: 10.1002/mds.10465.


We evaluated the incremental cost-effectiveness of cabergoline compared with levodopa monotherapy in patients with early Parkinson's disease (PD) in the German healthcare system. The study design was based on cost-effectiveness analysis using a Markov model with a 10-year time horizon. Model input data was based on a clinical trial "Early Treatment of PD with Cabergoline" as well as on cost data of a German hospital/office-based PD network. Direct and indirect medical and nonmedical costs were included. Outcomes were costs, disease stage, cumulative complication incidence, and mortality. An annual discount rate of 5% was applied and the societal perspective was chosen. The target population included patients in Hoehn and Yahr Stages I to III. It was found that the occurrence of motor complications was significantly lower in patients on cabergoline monotherapy. For patients aged >/=60 years of age, cabergoline monotherapy was cost effective when considering costs per decreased UPDRS score. Each point decrease in the UPDRS (I-IV) resulted in costs of euro;1,031. Incremental costs per additional motor complication-free patient were euro;104,400 for patients <60 years of age and euro;57,900 for patients >/=60 years of age. In conclusion, this decision-analytic model calculation for PD was based almost entirely on clinical and observed data with a limited number of assumptions. Although costs were higher in patients on cabergoline, the corresponding cost-effectiveness ratio for cabergoline was at least as favourable as the ratios for many commonly accepted therapies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / economics*
  • Antiparkinson Agents / therapeutic use*
  • Cabergoline
  • Cost-Benefit Analysis
  • Decision Making*
  • Disease Progression
  • Ergolines / adverse effects
  • Ergolines / economics*
  • Ergolines / therapeutic use*
  • Female
  • Humans
  • Levodopa / adverse effects
  • Levodopa / economics*
  • Levodopa / therapeutic use*
  • Male
  • Markov Chains
  • Middle Aged
  • Parkinson Disease / diagnosis
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / economics*
  • Severity of Illness Index


  • Antiparkinson Agents
  • Ergolines
  • Levodopa
  • Cabergoline