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Flexibility of Markov modeling for clinical pharmacoeconomics: illustration for cost–effectiveness in early Parkinson’s disease

Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disorder that results in degeneration of dopamin-ergic neurons in the substantia nigra (part of the midbrain). The dopamin-ergic deficiency in the corpus striatum results in motor complications and other functional impairment. PD is generally characterized by signs and symptoms of bradykinesia, rigidity, tremor and pos-tural instability. PD is not limited to motor symptoms, but depression, demen-tia and psychosis are also likely to occur as a result of PD progression