Volume 29, Issue 13 p. 1666-1674
Brief Report

Cost of deep brain stimulation for the treatment of Parkinson's disease by surgical stimulation sites

Kevin T. Stroupe PhD

Corresponding Author

Kevin T. Stroupe PhD

Hines VA Hospital, Center for Management of Complex Chronic Healthcare, Hines, Illinois, USA

Loyola University Stritch School of Medicine, Maywood, Illinois, USA

Correspondence to: Dr. Kevin T. Stroupe, Center of Innovation for Complex Chronic Care, Edward Hines, Jr. VA Hospital, 5000 South 5th Ave (151H), Hines, IL 60141, E-mail: [email protected]Search for more papers by this author
Frances M. Weaver PhD

Frances M. Weaver PhD

Hines VA Hospital, Center for Management of Complex Chronic Healthcare, Hines, Illinois, USA

Loyola University Stritch School of Medicine, Maywood, Illinois, USA

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Lishan Cao MS

Lishan Cao MS

Hines VA Hospital, Center for Management of Complex Chronic Healthcare, Hines, Illinois, USA

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Dolores Ippolito MPH

Dolores Ippolito MPH

Hines VA Hospital, Center for Management of Complex Chronic Healthcare, Hines, Illinois, USA

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Brandon R. Barton MD, MS

Brandon R. Barton MD, MS

Rush University Medical Center, Chicago, Illinois, USA

Jesse Brown VA Medical Center, Chicago, Illinois, USA

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Inger E. Burnett-Zeigler PhD

Inger E. Burnett-Zeigler PhD

Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA

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Robert G. Holloway MD, MPH

Robert G. Holloway MD, MPH

University of Rochester Medical Center, Rochester, New York, USA

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Barbara G. Vickrey MD, MPH

Barbara G. Vickrey MD, MPH

VA Greater Los Angeles Healthcare System, VA Southwest PADRECC, Los Angeles, California, USA

UCLA Department of Neurology, Los Angeles, California, USA

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Tanya Simuni MD

Tanya Simuni MD

Northwestern University, Parkinson's Disease and Movement Disorders Center, Chicago, Illinois, USA

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Kenneth A. Follett MD, PhD

Kenneth A. Follett MD, PhD

University of Nebraska School of Medicine, Omaha, Nebraska, USA

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First published: 15 September 2014
Citations: 25

Funding agencies: This study was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (Project Number: IIR 08-124-2). Dr. Weaver was also supported by a VA Research Career Scientist Award.

Relevant conflicts of interest/financial disclosures: Nothing to report.

Author roles may be found in the online version of this article.

Abstract

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