Rasagiline and Dopamine to Treat Parkinson’s Disease

Berlin, Germany—After controlling for several variables, patients with Parkinson’s disease who began therapy with rasagiline had a significantly lower probability of being hospitalized, significantly fewer hospitalizations, and shorter length of stay in the hospital compared with those who started therapy by taking a dopamine agonist, according to a database analysis.

The results were presented during a poster session at the ISPOR European Congress. The poster was titled Comparison of Hospitalizations among Parkinson’s Patients Who Initiated Therapy with a Dopamine Agonist or Rasagiline: Evidence from the Medicare Supplemental Database.

In 2006, the FDA approved rasagiline as initial monotherapy or as an adjunct therapy to levodopa to treat the signs and symptoms of idiopathic Parkinson’s disease. The drug, marketed by Teva CNS (Central Nervous System), comes in 0.5-mg and 1-mg tablets. Dopamine agonists are also commonly prescribed to treat Parkinson’s disease.

In this study, the authors examined information from the Thomson Reuters MarketScan^® Medicare Supplemental Database from February 1, 2006, through December 31, 2011. They included patients ≥65 years of age who were prescribed rasagiline or a dopamine agonist, were diagnosed with Parkinson’s disease in the 3 years after being prescribed the drugs, and had continuous insurance coverage from 6 months prior to receiving the medication until the 3 years after getting the prescription.

They used logistic regression to estimate hospitalizations and odds and used negative binomial regressions to estimate the length of stay in hospitals and number of hospitalizations. In addition, they used a 2-part multivariate model to estimate the costs associated with the hospitalizations, with the first part estimating the probability of being hospitalized and the second part estimating the costs of those patients who were hospitalized.

The study included 5886 people who took a dopamine agonist and 1234 who took rasagiline. Mean age was 76 years, 58.4% of patients were males, 33.7% lived in the North Central United States, and 30.1% lived in the Southern United States. Further, 48.4% had comprehensive insurance coverage and 36.1% were enrolled in a preferred provider organization for supplemental insurance.

The authors controlled for patient characteristics, general health, disability status, comorbid diagnoses, and index prescription characteristics.

Mean costs associated with hospitalizations for patients who took rasagiline were $12,327 compared with $16,525 for those who began with a dopamine agonist, a 24% difference (P<.0001). The rasagiline group also had a significantly lower probability of hospitalization during the 3 years following treatment initiation (odds ratio, 0.755; 95% confidence interval, 0.663-0.860), had significantly fewer hospitalizations (a mean of 0.21 days fewer than those taking a dopamine agonist; P<.0001), and a significantly shorter length of stay in hospitals (a mean of 0.38 days fewer than those taking a dopamine agonist; P<.0001).

This study was supported by Teva Pharmaceuticals Industries, Ltd.