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The economic consequences of introducing deep brain stimulation for the treatment of advanced Parkinson's disease in Australia
Author(s) -
Hollingsworth Bruce P.,
Harris Anthony H.
Publication year - 2003
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/j.1741-6612.2003.tb00482.x
Subject(s) - deep brain stimulation , pallidotomy , medicine , quality of life (healthcare) , parkinson's disease , disease , physical medicine and rehabilitation , physical therapy , nursing
Objectives: Parkinson's disease is a debilitating condition, which is increasing in prevalence as elderly populations increase in the developed world. As such, resource consumption will also increase. For advanced Parkinsons, where drug therapy is no longer effective, there are two surgical options ‐ ablative surgery, a one‐off procedure which destroys part of the brain, and deep brain stimulation (DBS), which uses electrodes to stimulate part of the brain. The specific question to be answered here is what the costs to the community of DBS are compared to ablative surgery (thalmotomy or pallidotomy) in potentially relieving the symptoms of advanced Parkinson's disease, and if there is any improvement in patients' quality of life. Design: A cost effectiveness study is undertaken. UK and Australian data are made use of and cost‐effectiveness estimated in terms of cost per change in functional ability. Setting: Hospital, community and home care. Patients: Those with advanced Parkinson's Disease. Main outcome measures: Frenchay index of functional ability. Results: It is estimated that the incremental extra cost for a small change in ability to undertake daily tasks is at least 23,559. Conclusions: As outcomes evidence is of low quality, at this stage it is not possible to establish that Deep Brain Stimulation offers substantial improvements in quality of life. Extra costs over ablative surgery are estimated to be in the range of 17,830 to 51,385 per patient over a five year period.