Delaying the use of subcutaneous Parkinson’s disease treatments by one year increases annual medical costs by 59.1%, AbbVie-sponsored research found.
The study, which researchers will present (PDF) at the AMCP Nexus Conference this month, modeled the impact of delaying the initiation of two subcutaneous therapies by one year. One therapy comprised foslevodopa and foscarbidopa, the combination that AbbVie sells as Vyalev. The other therapy featured apomorphine, the active ingredient in Supernus Pharmaceuticals’ Onapgo.
In the model, patients who received oral standard of care for one year had worse outcomes than their peers who started subcutaneous therapy immediately. Over three years, delayed treatment resulted in 2.3 more OFF hours per patient per day, on average. The delayed cohort experienced 0.9 more OFF hours per day at Year 3, despite having been on the subcutaneous treatment for two years at that point.
Annual medical costs per patient were $22,233 higher in the delayed-treatment cohort. Researchers attributed the 59.1% increase in costs to additional emergency room visits, hospitalizations and nursing home care. Delayed care was associated with other knock-on costs. Reduced work productivity in the delayed cohort resulted in an annual loss of $2,614 per patient and caregiver.
The researchers framed the results as evidence that “relatively modest delays in optimal treatment initiation can have substantial downstream clinical, humanistic, economic and societal consequences.”
That conclusion echoes findings from a study shared early this month at the 2026 International Congress of Parkinson’s Disease and Movement Disorders (MDS). The studies used the same approach to model the effect of delaying the use of the same subcutaneous therapies, and both reported 2.3 additional OFF hours per day.
The MDS study dug deeper into the clinical consequences of the OFF hours. Researchers linked delayed treatment to two extra falls, as well as increases in nursing home days and hospital nights of 97.6% and 60.2%, respectively, over three years. Hospitalizations, emergency room visits and long-term care use increased by 45.8%, 48.8% and 31.9%, respectively.
AbbVie could benefit if the findings encourage physicians to start patients on subcutaneous therapy earlier. Sales of Vyalev, which the FDA approved two years ago, reached $457 million over the first half of the year. With sales rising 27% sequentially in the second quarter, Vyalev is “well on track to achieve blockbuster sales this year,” AbbVie Chief Commercial Officer Jeffrey Stewart said on a July earnings call.
Sales of Onapgo, which received FDA approval in February 2025, totaled $21.9 million in the first six months of this year. Supply constraints have limited sales. Supernus aims to receive FDA approval for a second supplier by mid-2027.