Cost Effectiveness of Deep Brain Stimulation for Parkinson's Disease: A Systematic Review.

Journal

Applied health economics and health policy

ISSN: 1179-1896

Titre abrégé: Appl Health Econ Health Policy

Pays: New Zealand

ID NLM: 101150314

Informations de publication

Date de publication:
28 Nov 2023

Historique:

accepted: 24 10 2023

medline: 28 11 2023

pubmed: 28 11 2023

entrez: 28 11 2023

Statut: aheadofprint

Résumé

Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD) in patients with advanced motor symptoms with an inadequate response to pharmacotherapies. Despite its effectiveness, the cost effectiveness of DBS remains a subject of debate. This systematic review aims to update and synthesize evidence on the cost effectiveness of DBS for PD. To identify full economic evaluations that compared the cost effectiveness of DBS with other best medical treatments, a comprehensive search was conducted of the PubMed, Embase, Scopus, and Tufts Cost-Effective Analysis registry databases. The selected papers were systematically reviewed, and the results were summarized. For the quality appraisal, we used the modified economic evaluations bias checklist. The review protocol was a priori registered with PROSPERO, CRD42022345508. Sixteen identified cost-utility analyses that reported 19 comparisons on the use of DBS for PD were systematically reviewed. The studies were primarily conducted in high-income countries and employed Markov models. The costs considered were direct costs: surgical expenses, calibration, pulse generator replacement, and annual drug expenses. The majority of studies used country-specific thresholds. Fourteen comparisons from 12 studies reported on the cost effectiveness of DBS compared to best medical treatments. Eleven comparisons reported DBS as cost effective based on incremental cost-utility ratio results. The cost effectiveness of DBS for PD varies by time horizon, costs considered, threshold utilized, and stage of PD progression. Standardizing approaches and comparing DBS with other treatments are needed for future research on effective PD management.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE

METHODS METHODS

To identify full economic evaluations that compared the cost effectiveness of DBS with other best medical treatments, a comprehensive search was conducted of the PubMed, Embase, Scopus, and Tufts Cost-Effective Analysis registry databases. The selected papers were systematically reviewed, and the results were summarized. For the quality appraisal, we used the modified economic evaluations bias checklist. The review protocol was a priori registered with PROSPERO, CRD42022345508.

RESULTS RESULTS

Sixteen identified cost-utility analyses that reported 19 comparisons on the use of DBS for PD were systematically reviewed. The studies were primarily conducted in high-income countries and employed Markov models. The costs considered were direct costs: surgical expenses, calibration, pulse generator replacement, and annual drug expenses. The majority of studies used country-specific thresholds. Fourteen comparisons from 12 studies reported on the cost effectiveness of DBS compared to best medical treatments. Eleven comparisons reported DBS as cost effective based on incremental cost-utility ratio results.

CONCLUSIONS CONCLUSIONS

The cost effectiveness of DBS for PD varies by time horizon, costs considered, threshold utilized, and stage of PD progression. Standardizing approaches and comparing DBS with other treatments are needed for future research on effective PD management.

Identifiants

DOI: 10.1007/s40258-023-00848-y PMID: 38015368

pubmed: 38015368

doi: 10.1007/s40258-023-00848-y

pii: 10.1007/s40258-023-00848-y

doi:

Types de publication

Systematic Review

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : Dept. of Health Research Govt. of India

ID : HTA-Resource centre grant

Informations de copyright

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