Nuijten M J, van Iperen P, Palmer C, van Hilten B J, Snyder E
MEDTAP International, Dorpsstraat 75, 1526 LG Jisp, Amsterdam, The Netherlands.
Value Health. 2001 Jul-Aug;4(4):316-28. doi: 10.1046/j.1524-4733.2001.44037.x.
The objective of this study was to examine the cost-effectiveness of a complementary treatment with entacapone versus usual care only in patients with Parkinson's disease.
The setting for this study was the Netherlands. A Markov process model was constructed to model the average quality-adjusted life years (QALYs) and the costs of both treatments. The model examined a period of 5 years in order to capture the influence of symptom improvement and disease progression. Data for the construction of the model were derived from published literature, including large, multicenter, randomized clinical trials in patients with end-of-dose motor fluctuations. Costs were obtained from published sources.
The results of the baseline analysis showed that the use of entacapone as complementary therapy in Parkinson's disease slightly decreased the total average discounted costs from NLG 111,317 to NLG 110,038, while effectiveness increased from 2.42 to 2.56 QALYs (a 6% increase). In addition, entacapone substantially increased time without severe fluctuations by 0.63 years. Sensitivity analyses confirmed the robustness of these findings.
The study shows that entacapone is a cost-effective treatment in patients with Parkinson's disease: entacapone yields higher effectiveness in terms of both effectiveness measures (time without severe fluctuations and QALYs), while costs remain quite similar to those for usual care. The additional drug costs for entacapone are offset by reductions in other costs.
本研究旨在探讨恩他卡朋作为辅助治疗与仅采用常规护理相比，在帕金森病患者中的成本效益。
本研究在荷兰开展。构建了一个马尔可夫过程模型，以模拟两种治疗方法的平均质量调整生命年（QALY）和成本。该模型考察了5年的时间，以捕捉症状改善和疾病进展的影响。构建模型的数据来源于已发表的文献，包括针对剂末运动波动患者的大型多中心随机临床试验。成本数据来自已发表的资料。
基线分析结果显示，在帕金森病中使用恩他卡朋作为辅助治疗，使总平均贴现成本从111,317荷兰盾略微降至110,038荷兰盾，而有效性从2.42个QALY增加到2.56个QALY（增加了6%）。此外，恩他卡朋使无严重波动的时间大幅增加了0.63年。敏感性分析证实了这些结果的稳健性。
该研究表明，恩他卡朋对帕金森病患者来说是一种具有成本效益的治疗方法：在有效性指标（无严重波动的时间和QALY）方面，恩他卡朋产生了更高的有效性，而成本与常规护理相当。恩他卡朋额外的药物成本被其他成本的降低所抵消。
