Universität zu Köln

Dams, Judith, Balzer-Geldsetzer, Monika, Siebert, Uwe ORCID: 0000-0001-6425-7671, Deuschl, Guenther, Schuepbach, W. M. Michael, Krack, Paul ORCID: 0000-0002-3508-7295, Timmermann, Lars, Schnitzler, Alfons ORCID: 0000-0002-6414-7939, Reese, Jens-Peter and Dodel, Richard (2016). Cost-effectiveness of neurostimulation in Parkinson's disease with early motor complications. Mov. Disord., 31 (8). S. 1183 - 1192. HOBOKEN: WILEY-BLACKWELL. ISSN 1531-8257

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Abstract

BackgroundRecent research efforts have focused on the effects of deep brain stimulation of the subthalamic nucleus (STN DBS) for selected patients with mild-to-moderate PD experiencing motor complications. ObjectivesWe assessed the cost utility of subthalamic DBS compared with the best medical treatment for German patients below the age of 61 with early motor complications of PD. MethodsWe applied a previously published Markov model that integrated health utilities based on EuroQoL and direct costs over patients' lifetime adjusted to the German health care payer perspective (year of costing: 2013). Effectiveness was evaluated using the Parkinson's Disease Questionnaire 39 summary index. We performed sensitivity analyses to assess uncertainty. ResultsIn the base-case analysis, the incremental cost-utility ratio for STN DBS compared to best medical treatment was 22,700 Euros per quality-adjusted life year gained. The time to, and costs for, battery exchange had a major effect on the incremental cost-utility ratios, but never exceeded a threshold of 50,000 Euros per quality-adjusted life year. ConclusionsOur decision analysis supports the fact that STN DBS at earlier stages of the disease is cost-effective in patients below the age of 61 when compared with the best medical treatment in the German health care system. This finding was supported by detailed sensitivity analyses reporting robust results. Whereas the EARLYSTIM study has shown STN DBS to be superior to medical therapy with respect to quality of life for patients with early motor complications, this further analysis has shown its cost-effectiveness. (c) 2016 International Parkinson and Movement Disorder Society

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dams, Judith UNSPECIFIED UNSPECIFIED UNSPECIFIED Balzer-Geldsetzer, Monika UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Uwe UNSPECIFIED orcid.org/0000-0001-6425-7671 UNSPECIFIED Deuschl, Guenther UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuepbach, W. M. Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Krack, Paul UNSPECIFIED orcid.org/0000-0002-3508-7295 UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnitzler, Alfons UNSPECIFIED orcid.org/0000-0002-6414-7939 UNSPECIFIED Reese, Jens-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Dodel, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-267509
DOI:	10.1002/mds.26740
Journal or Publication Title:	Mov. Disord.
Volume:	31
Number:	8
Page Range:	S. 1183 - 1192
Date:	2016
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1531-8257
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; SUBTHALAMIC NUCLEUS; FOLLOW-UP; METAANALYSIS; PREDICTORS; OUTCOMES; GERMANY; TRIAL; LIFE Multiple languages Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26750