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Cost of deep brain stimulation for the treatment of Parkinson's disease by surgical stimulation sites
Author(s) -
Stroupe Kevin T.,
Weaver Frances M.,
Cao Lishan,
Ippolito Dolores,
Barton Brandon R.,
BurnettZeigler Inger E.,
Holloway Robert G.,
Vickrey Barbara G.,
Simuni Tanya,
Follett Kenneth A.
Publication year - 2014
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26029
Subject(s) - deep brain stimulation , parkinson's disease , subthalamic nucleus , medicine , quality of life (healthcare) , confidence interval , randomized controlled trial , randomization , clinical trial , disease , physical therapy , physical medicine and rehabilitation , surgery , nursing
Objective To assess costs and effectiveness of deep brain stimulation (DBS) of the internal globus pallidum (GPi) versus subthalamic nucleus (STN) from the provider and societal perspectives for Parkinson's disease (PD) patients in a multicenter randomized trial. Methods All costs from randomization to 36 months were included. Costs were from Department of Veterans Affairs (VA) and Medicare databases and clinical trial data. Quality adjusted life years (QALYs) were from Quality of Well Being questionnaires. Results Provider costs were similar for the 144 GPi and 130 STN patients (GPi: $138,044 vs. STN: $131,822; difference = $6,222, 95% confidence interval [CI]: –$42,125 to $45,343). Societal costs were also similar (GPi: $171,061 vs. STN: $167,706; difference = $3,356, 95% CI: –$57,371 to $60,294). The GPi patients had nonsignificantly more QALYs. Conclusions The QALYs and costs were similar; the level of uncertainty given the sample size suggests that these factors should not direct treatment or resource allocation decisions in selecting or making available either procedure for eligible PD patients. © 2014 International Parkinson and Movement Disorder Society