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Message From: Jorge A Romero <[log in to unmask]> Cabergoline, a dopamine agonist, is marketed by Pharmacia/Upjohn in the US as DOSTINEX. In Europe, the same company markets it as CABASER In the treatment of Parkinsonism, in Europe, it has received very good reviews. It has a long duration of action so that once daily administration is enough. In the United States it was approved by the FDA in 1996 for the treatment of hyperprolactenemia in women. Hyperprolactenemia is a condition which causes abnormal lactation. The catch: The company has marketed it and priced it for the treatment of hyperprolactinemia ( two 0.5 mg tablets a week suffice. The retail cost of 8 tablets is $235, or nearly $30 per tablet.) For $235 one obtains one month therapy for hyperprolactinemia. For Parkinsonism, the daily dosage ranges from 0.5 mg to 4 mg per day (in some studies as high as 6 mg/day) and therefore the cost would be prohibitive ( and I bet insurance companies would refuse to cover it.) The minimum cost would be at least $1000 per month at those prices, and more likely to be two or three times that, or even more that, depending on the dosage. Perhaps some pressure from PWPs may expedite its approval by the FDA for Parkinsonism in the US, and more realistic pricing by the drug company. It is my understanding that Pharmacia/Upjohn made a deliberate decision to market pramipexole in the US instead of cabergoline, for Parkinsonism. Pramipexole was approved by the FDA in 1997. Cabergoline was approved for hyperprolactenemia in December 1996. The literature on cabergoline and parkinson's disease goes back to the early 1990s. It is possible that the failure of the FDA to approve it for Parkinson's Disease may have more to do with Pharmacia/Upjohn's marketing strategies than with any inherent scientific difficulties in its approval. I do not know what efforts Pharmacia/Upjohn has made to market cabergoline in the US, but it would make sense to speculate that they would not try very hard to market a drug to compete with pramipexole, which is also theirs, and has been recently introduced. Jorge Romero, MD ----- Original Message ----- From: "Nigel Harland" <[log in to unmask]> To: <[log in to unmask]> Sent: Thursday, January 24, 2002 1:56 PM Subject: Cabaser > Carol, > It is my understanding that Cabaser has not yet been approved in > the USA for the treatment of PD. > However, I believe it is available under another name, Dostinex ?? as a > treatment for lactation problems in women. > I have seen it marketed over here under both names. > Perhaps an understanding Neuro' might consider prescribing it for PD. > Regards, > Nigel > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn