On 9 January 2024, AbbVie announced the launch of Produodopa (foscarbidopa/foslevodopa) in the EU, to treat severe motor fluctuations in patients with advanced Parkinson’s disease (PD).

The treatment uses a VYAFUSER pump that maintains a continuous steady flow of levodopa throughout the day to control motor fluctuations in the form of off-episodes, dyskinesia, and hyperkinesia.

This novel delivery system of levodopa is expected to offer non-invasive administration, reduce pill burden, and improve compliance while treating motor fluctuations in advanced PD patients. AbbVie’s Produodopa is the first-to-market subcutaneous infusion of levodopa, and it holds potential to become the first-choice pump for patients with advanced PD.

Produodopa is an alternative to AbbVie’s own Duodopa (levodopa/carbidopa), launched in 2015, an intestinal gel administered with an external portable pump connected to a permanent tube through endoscopic gastrostomy.

Produodopa has strong advantages

According to GlobalData’s POLI Price Intelligence database, Produodopa is priced at parity to Duodopa and has strong advantages over Duodopa. Key opinion leaders (KOLs) previously interviewed by GlobalData noted that the burden of the surgery and carrying the pumping apparatus required for Duodopa treatment can often cause severe discomfort for patients.

The smaller size of the Produodopa pump is regarded as an advantage over Duodopa and is a welcomed option that does not require invasive surgical procedures.

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More competition

However, Produodopa will compete with continuous subcutaneous infusion of apomorphine, Britannia Pharmaceuticals’ Apo-go pump, which has been prescribed as an adjunctive therapy in Europe for the past 20 years for patients who still experience motor complications despite four or five doses of levodopa during the day.

The Apo-go pump has an average annual cost of therapy that is a third of the price of Produodopa. NICE recommends Produodopa for advanced PD patients who are unsuitable for apomorphine or deep brain stimulation treatment, or for when these treatments provide inadequate control of motor symptoms.

However, when comparing the subcutaneous continuous infusion of apomorphine with levodopa, KOLs stated a preference for levodopa formulations as it is the naturally occurring precursor to dopamine that is converted in the brain. As such, Produodopa is expected to be the preferred subcutaneous delivery system, but its premium pricing is coupled with reimbursement policies where patients must try the Apo-go pump before Produodopa can be offered, acting as barriers to its uptake.

Produodopa’s market entry will be followed by NeuroDerm’s ND-0612 continuous subcutaneous (carbidopa + levodopa) pump. GlobalData forecasts ND-0612 to launch in the EU in Q2 2025. KOLs noted that the administration of ND-0612 requires two injection entry points compared to Produodopa’s one. In addition, Produodopa may offer greater dosing flexibility, allowing higher concentrations of levodopa to be administered compared to ND-0612.

However, head-to-head clinical trials comparing the efficacy of Produodopa and ND-0612 do not appear to be on the horizon yet. Should ND-0612 receive approval, ND-0612 will need strong efficacy data and competitive pricing to displace Produodopa as the first-choice levodopa subcutaneous pump for patients with advanced PD.