IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v42y2024i1d10.1007_s40273-023-01318-y.html
   My bibliography  Save this article

Economic Evaluations Comparing Deep Brain Stimulation to Best Medical Therapy for Movement Disorders: A Meta-Analysis

Author

Listed:
  • Melissa Lannon

    (McMaster University)

  • Taylor Duda

    (McMaster University)

  • Alexander Mastrolonardo

    (McMaster University)

  • Ellissa Huang

    (McMaster University)

  • Amanda Martyniuk

    (McMaster University)

  • Forough Farrokhyar

    (McMaster University)

  • Feng Xie

    (McMaster University)

  • Mohit Bhandari

    (McMaster University
    McMaster University)

  • Suneil K. Kalia

    (University of Toronto)

  • Sunjay Sharma

    (McMaster University
    McMaster University)

Abstract

Background Movement disorders (Parkinson’s disease, essential tremor, primary dystonia) are a debilitating group of conditions that are progressive in nature. The mainstay of treatment is best medical therapy; however, a number of surgical therapies are available, including deep brain stimulation. Economic evaluations are an important aspect of evidence to inform decision makers regarding funding allocated to these therapies. Objective This systematic review and meta-analysis evaluated the cost effectiveness of including deep brain stimulation compared with best medical therapy for movement disorder indications in the adult population. Methods Ovid Medical Literature Analysis and Retrieval System Online, Embase, and Cochrane Central Register of Controlled Trials were queried. Only economic evaluations reporting incremental cost-effectiveness ratios for including deep brain stimulation versus best medical therapy for movement disorders were included. Studies were reviewed in duplicate for inclusion and data abstraction. Data were harmonized using the Consumer Price Index and Purchasing Power Parity to standardize values to 2022 US dollars. For inclusion in meta-analyses, studies were required to have sufficient data available to calculate an estimate of the incremental net benefit. Meta-analyses of pooled incremental net benefit based on the time horizon were performed. The study was registered at PROSPERO (CRD42022335436). Results There were 2190 studies reviewed, with 14 economic evaluations included following a title/abstract and full-text review. Only studies considering Parkinson’s disease were available for the meta-analysis. Quality of the identified studies was low, with moderate transferability to the American Healthcare System, and certainty of evidence was low. However, studies with a longer time horizon (15 years to lifetime) were found to have significant positive incremental net benefit (indicating cost effectiveness) for including deep brain stimulation with a mean difference of US$40,504.81 (95% confidence interval 2422.42–78,587.19). Conclusions Deep brain stimulation was cost effective for Parkinson’s disease when considered over the course of the patient’s remaining life after implantation. Trial Registration Clinical Trial Registration: PROSPERO (CRD42022335436).

Suggested Citation

  • Melissa Lannon & Taylor Duda & Alexander Mastrolonardo & Ellissa Huang & Amanda Martyniuk & Forough Farrokhyar & Feng Xie & Mohit Bhandari & Suneil K. Kalia & Sunjay Sharma, 2024. "Economic Evaluations Comparing Deep Brain Stimulation to Best Medical Therapy for Movement Disorders: A Meta-Analysis," PharmacoEconomics, Springer, vol. 42(1), pages 41-68, January.
    • Handle: RePEc:spr:pharme:v:42:y:2024:i:1:d:10.1007_s40273-023-01318-y
    DOI: 10.1007/s40273-023-01318-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-023-01318-y
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40273-023-01318-y?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kevin Schulman & Jennifer Burke & Michael Drummond & Linda Davies & Per Carlsson & Jans Gruger & Anthony Harris & Carlo Lucioni & Ramon Gisbert & Ted Llana & Eric Tom & Bernard Bloom & Richard Willke , 1998. "Resource costing for multinational neurologic clinical trials: methods and results," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 629-638, November.
    2. Judith Dams & Johann-Jacob Zapp & Hans-Helmut König, 2023. "Modelling the Cost Effectiveness of Treatments for Parkinson’s Disease: An Updated Methodological Review," PharmacoEconomics, Springer, vol. 41(10), pages 1205-1228, October.
    3. Brooks, Richard G. & Jendteg, Stefan & Lindgren, Bjorn & Persson, Ulf & Bjork, Stefan, 1991. "EuroQol(c): health-related quality of life measurement. Results of the Swedish questionnaire exercise," Health Policy, Elsevier, vol. 18(1), pages 37-48, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Johannesson, Magnus & Johansson, Per-Olov, 1996. "The economics of ageing: on the attitude of Swedish people to the distribution of health care resources between the young and the old," Health Policy, Elsevier, vol. 37(3), pages 153-161, September.
    2. Malin Ulfsdotter & Lene Lindberg & Anna Månsdotter, 2015. "A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-16, December.
    3. Alan Williams, 1995. "The role of the Euroqol instrument in QALY calculations," Working Papers 130chedp, Centre for Health Economics, University of York.
    4. Irina Cleemput, 2010. "A social preference valuations set for EQ-5D health states in Flanders, Belgium," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 205-213, April.
    5. McCrone, Paul R. & Chisholm, Daniel & Knapp, Martin & Hughes, Richard & Comi, Giancarlo & Dalakas, Marinos C. & Illa, Isabel & Kilindireas, Costas & Nobile-Orazio, Eduardo & Swan, Anthony Victor & Van, 2003. "Cost-utility analysis of intravenous immunoglobulin and prednisolone for chronic inflammatory demyelinating polyradiculoneuropathy," LSE Research Online Documents on Economics 326, London School of Economics and Political Science, LSE Library.
    6. Andersson, Henrik & Hole, Arne Risa & Svensson, Mikael, 2016. "Valuation of small and multiple health risks: A critical analysis of SP data applied to food and water safety," Journal of Environmental Economics and Management, Elsevier, vol. 75(C), pages 41-53.
    7. Richard Grieve & John Cairns & Simon G. Thompson, 2010. "Improving costing methods in multicentre economic evaluation: the use of multiple imputation for unit costs," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 939-954, August.
    8. Andrew R. Willan & Eleanor M. Pinto & Bernie J. O'Brien & Padma Kaul & Ron Goeree & Larry Lynd & Paul W. Armstrong, 2005. "Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT‐3 economic analysis," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 327-338, April.
    9. Ulf Persson & Anna Trawén & Anna Norinder & Krister Hjalte & Henrik Andersson, 2001. "Relative risk values of non-fatal traffic injuries - a comparison between contingent valuation, risk-risk trade off and standard gamble methods," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 137(I), pages 117-128, March.
    10. Sarah Wordsworth & Anne Ludbrook, 2005. "Comparing costing results in across country economic evaluations: the use of technology specific purchasing power parities," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 93-99, January.
    11. Andersson, Henrik, 2013. "Consistency in preferences for road safety: An analysis of precautionary and stated behavior," Research in Transportation Economics, Elsevier, vol. 43(1), pages 41-49.
    12. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    13. Raymond Oppong & Joanna Coast & Kerry Hood & Jacqui Nuttall & Richard Smith & Christopher Butler, 2011. "Resource use and costs of treating acute cough/lower respiratory tract infections in 13 European countries: results and challenges," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 319-329, August.
    14. Jonas Schreyögg & Oliver Tiemann & Tom Stargardt & Reinhard Busse, 2008. "Cross‐country comparisons of costs: the use of episode‐specific transitive purchasing power parities with standardised cost categories," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 95-103, January.
    15. Daniel Polsky & Richard J. Willke & Karen Scott & Kevin A. Schulman & Henry A. Glick, 2001. "A comparison of scoring weights for the EuroQol© derived from patients and the general public," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 27-37, January.
    16. Jeffrey A. Johnson & Arto Ohinmaa & Bhisma Murti & Harri Sintonen & Stephen Joel Coons, 2000. "Comparison of Finnish and U.S.-based Visual Analog Scale Valuations of the EQ-5D Measure," Medical Decision Making, , vol. 20(3), pages 281-289, July.
    17. Henrik Andersson, 2011. "Perception of Own Death Risk: An Assessment of Road‐Traffic Mortality Risk," Risk Analysis, John Wiley & Sons, vol. 31(7), pages 1069-1082, July.
    18. Richard Grieve & Richard Nixon & Simon G. Thompson, 2010. "Bayesian Hierarchical Models for Cost-Effectiveness Analyses that Use Data from Cluster Randomized Trials," Medical Decision Making, , vol. 30(2), pages 163-175, March.
    19. Johansson-Stenman, Olof & Martinsson, Peter, 2008. "Are some lives more valuable? An ethical preferences approach," Journal of Health Economics, Elsevier, vol. 27(3), pages 739-752, May.
    20. Sarah Wordsworth & Anne Ludbrook & Fergus Caskey & Alison Macleod, 2005. "Collecting unit cost data in multicentre studies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 38-44, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:42:y:2024:i:1:d:10.1007_s40273-023-01318-y. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.