beneficiaries with Parkinson’s Disease (PD) had advanced 
disease. Yet, only 2% of those patients with advanced PD 
received a DAT, despite proven efficacy.3
Since 2000, when The Michael J. Fox Foundation 
began, the number of available medications for 
Parkinson’s disease has increased substantially, according 
to its website, which added, “Today, the therapeutic pipe-
line for Parkinson’s is the strongest in history. “
The foundation noted that, since 2024, the U.S. Food 
and Drug Administration (FDA) has approved three new 
drugs. 
Those include: 
	
• Crexont: This long-acting pill is designed to 
improve motor symptoms such as tremor, slowness 
and stiffness for a longer period with fewer doses. 
It combines an extended-release formulation 
of levodopa/carbidopa with immediate-release 
levodopa/carbidopa to reduce “off” time,  
when symptoms are less controlled.
	
• Vyalev: This infusion treatment aims to increase 
“on” time (when symptoms are well controlled) 
through a steady source of levodopa/carbidopa. 
The medication is delivered continuously under 
the skin through a pump.
	
• Onapgo: Also a continuous infusion of 
medication using a pump, it provides a constant 
supply of apomorphine, a dopamine agonist. 
Crexont was approved by the FDA in August 2024 
with an indication for the treatment of Parkinson’s dis-
ease, Parkinson’s disease caused by infection or inflam-
mation of the brain, or Parkinson’s disease-like symptoms 
that may result from carbon monoxide or manganese poi-
soning in adults.
The VA added Crexont to its formulary in early 
2025. Its healthcare system treats about 10% of all U.S. 
PD patients. For U.S. veterans, Parkinson’s disease can 
be a service-connected condition, with presumptive 
connection for those who served in specific locations 
or timeframes, and nonpresumptive service connection 
for those whose symptoms began during active military 
service, within one year of 
leaving service, or due to 
a traumatic brain injury 
(TBI). (For more informa-
tion, see sidebar, p. 67).
Patients prescribed the 
drug, as well as a first-gen-
eration product marketed 
as Rytary, must be under 
the care of a VA or VA 
Community Care neurolo-
gist or locally designated 
expert and have a clinical 
diagnosis 
of 
Parkinson’s 
disease (PD), post-enceph-
alitic 
Parkinsonism 
or 
Parkinsonism that may fol-
low intoxication by carbon 
monoxide or manganese. 
(Rytary was approved in 
2015 and requires more 
daily dosages.) 
They also need to have a 
problem with drugs “wear-
ing off” that require dosing 
of dopaminergic medica-
tions at intervals of every 
four hours or less, with a 
combination of carbidopa/
levodopa controlled-release 
	
	
2 0 2 6  C O M P E N D I U M  O F  F E D E R A L  M E D I C I N E  
6 3
Good On-Time at Visit 7/Early Termination.
Good on-time was defined as on-time without troublesome dyskinesia.  IR CD-LD 
indicates immediate-release carbidopa-levodopa.
Source: Aquino CC, Fox SH. Clinical spectrum of levodopa-induced complications. Mov Disord. 2015;30(1):80-89. doi: 
10.1002/mds.26125

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