Evidence map›Paper›PMID 35938258›Full record

Trial reportJournal of Parkinson's disease2022

Cost-Effectiveness and Cost-Utility of Early Levodopa in Parkinson's Disease.

Constant V M Verschuur, Sven R Suwijn, Rob J de Haan, Judith A Boel, Bart Post, Bas R Bloem, Johannes J van Hilten, Teus van Laar, Gerrit Tissingh, Alexander Munts and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of Parkinson's disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Constant V M VerschuurDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Sven R SuwijnDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Rob J de HaanDepartment of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Judith A BoelDepartment of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Bart PostDepartment of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
Bas R BloemDepartment of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
Johannes J van HiltenDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Teus van LaarDepartment of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Gerrit TissinghDepartment of Neurology, Zuyderland Medical Center, Heerlen, The Netherlands.
Alexander MuntsDepartment of Neurology, Excellent Klinieken, Dordrecht, The Netherlands.
Marcel G W DijkgraafDepartment of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Rob M A de BieDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the Levodopa in EArly Parkinson's disease (LEAP) study, 445 patients were randomized to levodopa/carbidopa 100/25 mg three times per day for 80 weeks (early-start) or placebo for 40 weeks followed by levodopa/carbidopa 100/25 mg three times per day for 40 weeks (delayed-start).

objectiveThis paper reports the results of the economic evaluation performed alongside the LEAP-study.

methodsEarly-start treatment was evaluated versus delayed-start treatment, in which the cost-effectiveness analysis (CEA) and the cost-utility analysis (CUA) were performed from the societal perspective, including health care costs among providers, non-reimbursable out-of-pocket expenses of patients, employer costs of sick leave, and lowered productivity while at work. The outcome measure for the CEA was the extra cost per unit decrease on the Unified Parkinson's Disease Rating Scale 80 weeks after baseline. The outcome measure for the CUA was the extra costs per additional quality adjusted life year (QALY) during follow-up.

results212 patients in the early-start and 219 patients in the delayed-start group reported use of health care resources. With savings of € 59 per patient (BCa 95% CI: -829, 788) in the early-start compared to the delayed-start group, societal costs were balanced. The early-start group showed a mean of 1.30 QALYs (BCa 95% CI: 1.26, 1.33) versus 1.30 QALYs (BCa 95% CI: 1.27, 1.33) for the delayed-start group. Because of this negligible difference, incremental cost-effectiveness and cost-utility ratios were not calculated.

conclusionFrom an economic point of view, this study suggests that early treatment with levodopa is not more expensive than delayed treatment with levodopa.

Indexed as

LevodopaParkinson DiseaseAntiparkinson AgentsCarbidopaCost-Benefit AnalysisHumansAntiparkinson AgentsCarbidopaLevodopacost analysislevodopaParkinson’s disease

Identifiers

PMID35938258
PMCPMC9661337

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.