Abstract
Objective: Deep brain stimulation (DBS) is an effective surgical option for treating Parkinson's disease (PD). DBS is invasive, with a high initial cost. In Japan, questions have been raised about its cost-effectiveness and the resulting improvements in outcome. The aim of this study was to evaluate the cost-effectiveness of DBS for PD in Japan, particularly whether early or late DBS is more cost-effective. Methods: We used a Markov cohort simulation to follow the clinical course of DBS for PD. We conducted a survey to capture QOL scores among healthy Japanese volunteers. Transition probabilities were estimated from randomized clinical trials. We determined direct medical costs from the perspective of the Japanese health care system. Outcomes were assessed as quality-adjusted life years. We conducted univariate and probabilistic sensitivity analyses. Results: DBS costs an additional 10.3 million Japanese yen (US$85,100; exchange rate on October 28, 2015 was 121 yen to $1) for a gain of 3.2 quality-adjusted life years. The incremental cost-effectiveness ratio was 3.1 million yen ($25,600). The incremental cost-effectiveness ratio was 8.5 million yen ($70,200) for early DBS, 3.1 million yen ($25,600) for intermediate DBS, and 3.3 million yen ($27,200) for late-stage DBS. Conclusions: Our model suggests that DBS is cost-effective in the Japanese health care system. DBS is more cost-effective if performed in the intermediate rather than early or late stages of PD.
| Original language | English |
|---|---|
| Journal | World Neurosurgery |
| DOIs | |
| Publication status | Accepted/In press - 2015 Aug 15 |
Fingerprint
Keywords
- Cost-effectiveness
- Deep brain stimulation
- Markov model
- Parkinson's disease
- QOL scores
- Quality-adjusted life-year
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Cost-Effectiveness Analysis of Deep Brain Stimulation in Patients with Parkinson's Disease in Japan. / Kawamoto, Yukiyoshi; Mouri, Mitsuko; Taira, Takaomi; Iseki, Hiroshi; Masamune, Ken.
In: World Neurosurgery, 15.08.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cost-Effectiveness Analysis of Deep Brain Stimulation in Patients with Parkinson's Disease in Japan
AU - Kawamoto, Yukiyoshi
AU - Mouri, Mitsuko
AU - Taira, Takaomi
AU - Iseki, Hiroshi
AU - Masamune, Ken
PY - 2015/8/15
Y1 - 2015/8/15
N2 - Objective: Deep brain stimulation (DBS) is an effective surgical option for treating Parkinson's disease (PD). DBS is invasive, with a high initial cost. In Japan, questions have been raised about its cost-effectiveness and the resulting improvements in outcome. The aim of this study was to evaluate the cost-effectiveness of DBS for PD in Japan, particularly whether early or late DBS is more cost-effective. Methods: We used a Markov cohort simulation to follow the clinical course of DBS for PD. We conducted a survey to capture QOL scores among healthy Japanese volunteers. Transition probabilities were estimated from randomized clinical trials. We determined direct medical costs from the perspective of the Japanese health care system. Outcomes were assessed as quality-adjusted life years. We conducted univariate and probabilistic sensitivity analyses. Results: DBS costs an additional 10.3 million Japanese yen (US$85,100; exchange rate on October 28, 2015 was 121 yen to $1) for a gain of 3.2 quality-adjusted life years. The incremental cost-effectiveness ratio was 3.1 million yen ($25,600). The incremental cost-effectiveness ratio was 8.5 million yen ($70,200) for early DBS, 3.1 million yen ($25,600) for intermediate DBS, and 3.3 million yen ($27,200) for late-stage DBS. Conclusions: Our model suggests that DBS is cost-effective in the Japanese health care system. DBS is more cost-effective if performed in the intermediate rather than early or late stages of PD.
AB - Objective: Deep brain stimulation (DBS) is an effective surgical option for treating Parkinson's disease (PD). DBS is invasive, with a high initial cost. In Japan, questions have been raised about its cost-effectiveness and the resulting improvements in outcome. The aim of this study was to evaluate the cost-effectiveness of DBS for PD in Japan, particularly whether early or late DBS is more cost-effective. Methods: We used a Markov cohort simulation to follow the clinical course of DBS for PD. We conducted a survey to capture QOL scores among healthy Japanese volunteers. Transition probabilities were estimated from randomized clinical trials. We determined direct medical costs from the perspective of the Japanese health care system. Outcomes were assessed as quality-adjusted life years. We conducted univariate and probabilistic sensitivity analyses. Results: DBS costs an additional 10.3 million Japanese yen (US$85,100; exchange rate on October 28, 2015 was 121 yen to $1) for a gain of 3.2 quality-adjusted life years. The incremental cost-effectiveness ratio was 3.1 million yen ($25,600). The incremental cost-effectiveness ratio was 8.5 million yen ($70,200) for early DBS, 3.1 million yen ($25,600) for intermediate DBS, and 3.3 million yen ($27,200) for late-stage DBS. Conclusions: Our model suggests that DBS is cost-effective in the Japanese health care system. DBS is more cost-effective if performed in the intermediate rather than early or late stages of PD.
KW - Cost-effectiveness
KW - Deep brain stimulation
KW - Markov model
KW - Parkinson's disease
KW - QOL scores
KW - Quality-adjusted life-year
UR - http://www.scopus.com/inward/record.url?scp=84970002422&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84970002422&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2015.11.062
DO - 10.1016/j.wneu.2015.11.062
M3 - Article
C2 - 26704203
AN - SCOPUS:84970002422
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -