title: Deep brain stimulation in late stage Parkinson's disease: a retrospective cost analysis in Germany.
abstract: During the last few years, deep brain stimulation (DBS) of the subthalamic nucleus (STN) has emerged as a promising therapy, alleviating major motor symptoms of Parkinson's disease (PD). However, in times of growing budgetary limitations, medical decisions are no longer merely based on clinical efficacy, but also on cost-effectiveness. Here we assess treatment costs (i. e. costs for conservative pharmacological treatment and all in-patient admissions) of 46 PD patients for one year before and two years after STN-DBS. The present data show that total treatment costs were increased by 32% for the first year and decreased by 54% for the second year of STN-DBS in comparison with preoperative values while the Unified Parkinson's Disease Rating Scale (UPDRS III) was significantly improved. The increase for the first year after surgery was mainly due to the implantation of the STN electrodes and the stimulation device. Taken together, STNDBS pays off from the second year of stimulation while motor symptoms are significantly improved. The present study provides first data of an important number of patients on clinical effectiveness and expenses in relation to STNDBS.
authors.affiliation: Department of Neurology, Charité Campus Virchow-Klinikum, Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany. wassilios.meissner@charite.de
authors.forename: Wassilios
authors.initials: W
authors.lastname: Meissner
authors.forename: Doreen
authors.initials: D
authors.lastname: Schreiter
authors.forename: Jens
authors.initials: J
authors.lastname: Volkmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Trottenberg
authors.forename: Gerd-Helge
authors.initials: GH
authors.lastname: Schneider
authors.forename: Volker
authors.initials: V
authors.lastname: Sturm
authors.forename: Guenther
authors.initials: G
authors.lastname: Deuschl
authors.forename: Andreas
authors.initials: A
authors.lastname: Kupsch
mesh_terms: D000704:Analysis of Variance; D003365:Costs and Cost Analysis; D046690:Deep Brain Stimulation / Q000191:economics* / Q000379:methods; D004358:Drug Therapy / Q000191:economics / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000191:economics* / Q000628:therapy; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome
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