| Summary: | CADTH undertook reanalyses to address uncertainty regarding the clinical benefits of apomorphine hydrochloride sublingual (APO SL) film. Aligned with the CADTH Clinical Review, given no differences in clinical efficacy or harms could be concluded, CADTH assumed: equal efficacy with respect to reduction in OFF hours per day, and equal rates of adverse events (AEs) and treatment discontinuation as a result of AEs. In the CADTH reanalyses, at the submitted price, APO SL was less costly when compared with the list price of apomorphine hydrochloride subcutaneous (APO SC), representing savings of $3,695 per patient over 5 years. Some uncertainties remain, as the model did not account for the need for subsequent or adjunctive treatments, treatment effect waning, or the natural disease progression of Parkinson disease (PD). When used as an adjunctive treatment for the management of PD, APO SL could represent a less expensive treatment option for the treatment of OFF episodes relative to APO SC; however, any price negotiations for APO SC would need to be considered for APO SL. There was further uncertainty with regard to the current usage of APO SC and whether it is reflective of current clinical management of OFF episodes
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