| Title |
The cost-effectiveness of deep brain stimulation in combination with best medical therapy, versus best medical therapy alone, in advanced Parkinson’s disease
|
|---|---|
| Published in |
Journal of Neurology, October 2013
|
| DOI | 10.1007/s00415-013-7148-z |
| Pubmed ID | |
| Authors |
Simon Eggington, Francesc Valldeoriola, K. Ray Chaudhuri, Keyoumars Ashkan, Elena Annoni, Günther Deuschl |
| Abstract |
Parkinson's disease (PD) is a complex progressive movement disorder leading to motor and non-motor symptoms that become increasingly debilitating as the disease advances, considerably reducing quality of life. Advanced treatment options include deep brain stimulation (DBS). While clinical effectiveness of DBS has been demonstrated in a number of randomised controlled trials (RCT), evidence on cost-effectiveness is limited. The cost-effectiveness of DBS combined with BMT, versus BMT alone, was evaluated from a UK payer perspective. Individual patient-level data on the effect of DBS on PD symptom progression from a large 6-month RCT were used to develop a Markov model representing clinical progression and capture treatment effect and costs. A 5-year time horizon was used, and an incremental cost-effectiveness ratio (ICER) was calculated in terms of cost per quality-adjusted life-years (QALY) and uncertainty assessed in deterministic sensitivity analyses. Total discounted costs in the DBS and BMT groups over 5 years were £68,970 and £48,243, respectively, with QALYs of 2.21 and 1.21, giving an incremental cost-effectiveness ratio of £20,678 per QALY gained. Utility weights in each health state and costs of on-going medication appear to be the key drivers of uncertainty in the model. The results suggest that DBS is a cost-effective intervention in patients with advanced PD who are eligible for surgery, providing good value for money to health care payers. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 1 | 25% |
| Mexico | 1 | 25% |
| United States | 1 | 25% |
| Unknown | 1 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 75% |
| Scientists | 1 | 25% |
Mendeley readers
The data shown below were compiled from readership statistics for 184 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Germany | 1 | <1% |
| Sweden | 1 | <1% |
| Belgium | 1 | <1% |
| China | 1 | <1% |
| Spain | 1 | <1% |
| United States | 1 | <1% |
| Unknown | 178 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 29 | 16% |
| Researcher | 28 | 15% |
| Student > Bachelor | 25 | 14% |
| Other | 20 | 11% |
| Student > Ph. D. Student | 17 | 9% |
| Other | 31 | 17% |
| Unknown | 34 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 65 | 35% |
| Neuroscience | 21 | 11% |
| Economics, Econometrics and Finance | 11 | 6% |
| Engineering | 8 | 4% |
| Psychology | 7 | 4% |
| Other | 36 | 20% |
| Unknown | 36 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 February 2018.
All research outputs
#5,903,138
of 23,905,714 outputs
Outputs from Journal of Neurology
#1,463
of 4,666 outputs
Outputs of similar age
#51,115
of 215,419 outputs
Outputs of similar age from Journal of Neurology
#12
of 48 outputs
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So far Altmetric has tracked 4,666 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.5. This one has gotten more attention than average, scoring higher than 68% of its peers.
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