Model Inputs	Category	Description
Microsimulation inputs	Baseline characteristics	Age, Hoehn and Yahr stage, and “OFF” hours per day were informed by the pivotal trial of apomorphine sublingual film[@94527] Mean (SD) age: 62.70 (8.95) years Mean (SD) “OFF” hours per day: 3.90 (1.81) Hoehn and Yahr stage probability Stage 1: 0.9% Stage 2: 73.2% Stage 3: 25.9% Stages 4 and 5: 0.0% Age and disease stage were updated at each 3-month cycle Probability of disease progression was derived from published literature[@94531] Number of “OFF” hours was calculated as the product of patient-reported number of daily “OFF” episodes and typical duration of an “OFF” episode at patient’s baseline; values were updated at each 3-month cycle
	Efficacy	Changes in “OFF” time resulting from “on-demand” treatments: Apomorphine sublingual film: –1.32 hours[@94532] Apomorphine hydrochloride injection: –1.32 hoursa Levodopa inhalation powder: –0.01 hours[@94532]
	Discontinuation	Three-month discontinuation rates were based on observed clinical trial data[@94527; @94530] or computed for apomorphine hydrochloride injection as follows: s(t) = Xt +tyb Apomorphine sublingual film: 27.8% Apomorphine hydrochloride injection: 15.8% Levodopa inhalation powder: 5.3%
	Mortality	Calculated from US life tables and adjusted for relative risk of death based on patient age and disease severity from published literature[@94535; @94549]
Cost inputs	Drug acquisition costs	WAC price per package[@94539] Apomorphine sublingual film: US$787.50 Apomorphine hydrochloride injection: US $1100.00 Levodopa inhalation powder: US $997.50 DACON: 1.0 dose per day for all treatments No rebates or discounts assumed for any treatment No “on-demand” treatment was considered to have zero “on-demand” treatment costs
	Medical costs	Changes in per-patient medical costs were based on baseline HRU units, HRU associated with one extra “OFF” hour, and cost per unit of HRU (see Online Supplementary Material Table S3 for values for hospitalization days, specialist visits, ER visits, and informal caregiver timec)[@94540; @94541],c,d
	AE costs	AEs were assumed to occur in the first 3-month cycle, as patients who discontinue due to AEs would likely discontinue in the first cycle AE incidence rates were derived from published literature[@94527; @94533; @94538] Unit cost for most AEs was based on HRU reported in the CADTH Pharmacoeconomic Report (see Online Supplementary Material Table S2)[@94538] Total annual AE costs Apomorphine sublingual film: US$359.59 Apomorphine hydrochloride injection: US$110.73 Levodopa inhalation powder: US$510.35
Utility inputs	Utility associated with “OFF” time	Baseline utility values associated with “OFF” time were derived from published literature[@94542]/extrapolation methods “OFF” episode category I (1–4 hours): 0.643 “OFF” episode category II (4–8 hours): 0.555 “OFF” episode category III (8–12 hours): 0.467e “OFF” episode category IV (12–16 hours): 0.379e Nonlinear utility gainf For the first “OFF” hour reduced: 0.044 For each additional hour after the first: 0.015
	Disutilities associated with AEs	HRQOL impact of specific AEs was incorporated as one-time disutilities during the first 3-month cycle Utility decrement values for AEs were obtained from published literature (see Online Supplementary Material Table S2)[@94540] Total AE disutilities Apomorphine sublingual film: 0.014 Apomorphine hydrochloride injection: 0.001 Levodopa inhalation powder: 0.059