𝔖 Bobbio Scriptorium
✦   LIBER   ✦

Prospective comparative study on cost-effectiveness of subthalamic stimulation and best medical treatment in advanced Parkinson's disease

✍ Scribed by Francesc Valldeoriola; Ossama Morsi; Eduardo Tolosa; Jordi Rumià; Maria José Martí; Pablo Martínez-Martín

Publisher
John Wiley and Sons
Year
2007
Tongue
English
Weight
152 KB
Volume
22
Category
Article
ISSN
0885-3185

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

This is an open, prospective, longitudinal study designed to compare two cohorts of patients with advanced Parkinson's disease during 1 year, one undergoing bilateral subthalamic stimulation (STN‐DBS) and the other receiving the best medical treatment (BMT), with respect to the clinical effects observed and the medical expenses produced. Assessments were done by using clinical measures and a generic health related quality of life scale. A questionnaire was used to collect direct healthcare resources. As a measure of cost‐effectiveness, we calculated life years gained adjusted by health‐related quality of life (QALY) and the incremental cost‐effectiveness ratio (ICER). Clinical and demographic variables of both groups were comparable at baseline. Total UPDRS scores improved from 50.5 ± 3.6 to 28.5 ± 3.8 in STN‐DBS patients and worsened from 44.3 ± 3.3 to 54.2 ± 4 in the control group. Pharmacological costs in the operated patients were 3,799 ± 940€, while in the BMT group the costs were 13,208 ± 4,966€. Other medical costs were 1,280 ± 720€ in the STN‐DBS group and 4,017 ± 2,962€ in BMT patients. Nondirect medical costs were 4,079 ± 1,289 in operated patients and 2,787 ± 1,209€ in the BMT group. Mean QALYs were 0.7611 ± 0.03 in STN‐DBS and 0.5401 ± 0.06 in BMT patients. In STN‐DBS patients, the ICER needed to obtain an improvement of one point in the total UPDRS score was of 239.8€ and the ICER/QALY was of 34,389€. Cost‐effectiveness parameters were mostly related to the degree of clinical improvement and the reduction of pharmacological costs after STN‐DBS. An ICER of 34,389€/QALY is within appropriate limits to consider subthalamic stimulation as an efficient therapy. © 2007 Movement Disorder Society

📜 SIMILAR VOLUMES

Effects of bilateral pallidal or subthal
Effects of bilateral pallidal or subthalamic stimulation on gait in advanced Parkinson's disease
✍ N. Allert; J. Volkmann; S. Dotse; H. Hefter; V. Sturm; H.-J. Freund 📂 Article 📅 2001 🏛 John Wiley and Sons 🌐 English ⚖ 368 KB 👁 1 views

## Abstract Bilateral high‐frequency stimulation of the internal globus pallidus (GPi) and the subthalamic nucleus (STN) both alleviate akinesia, rigidity, and tremor in idiopathic Parkinson's disease. To test the specific effect of these procedures on gait, we used quantitative gait analysis in ad

Estimating the costs of surgical innovat
Estimating the costs of surgical innovations: The case for subthalamic nucleus stimulation in the treatment of advanced Parkinson's disease
✍ Emma McIntosh; Alastair Gray; Tipu Aziz 📂 Article 📅 2003 🏛 John Wiley and Sons 🌐 English ⚖ 78 KB

## Abstract We estimated the current cost of deep brain stimulation surgery targeted on the subthalamic nucleus. The method used was a cost analysis using typical resource use patterns and unit costs from a leading surgical centre, detailed equipment costs from the manufacturer, and sensitivity ana

Comparative cognitive effects of bilater
Comparative cognitive effects of bilateral subthalamic stimulation and subcutaneous continuous infusion of apomorphine in Parkinson's disease
✍ Montse Alegret; Francesc Valldeoriola; MaJosé Martí; Manuela Pilleri; Carme Junq 📂 Article 📅 2004 🏛 John Wiley and Sons 🌐 English ⚖ 88 KB

## Abstract Bilateral subthalamic deep brain stimulation (STN‐DBS) and continuous subcutaneous infusion of apomorphine (APM‐csi) can provide a comparable improvement on motor function in patients with advanced Parkinson's disease (PD), but the mechanisms by which both therapies exert their effects