title: The costs and benefits of deep brain stimulation surgery for patients with dystonia: an initial exploration.
abstract: Objectives.  To perform a preliminary cost-utility and cost-benefit of deep brain stimulation (DBS) in the treatment of dystonia, Materials and Methods.  We conducted a prospective study of 26 patients undergoing DBS for the treatment of dystonia. We performed a cost-utility analysis using the Euroquol (EQ-5D) questionnaire. A cost-benefit analysis used the willingness-to-pay principle and costs of treatment were calculated retrospectively in order to calculate the cost-benefit. Results.  We found that the EQ-5D score improved from 29 to 76.2 points after surgery, an incremental utility of 0.47. There was an overall gain of 0.94 quality-adjusted life-years (QALY) with a cost of £33,980 per QALY. Conclusions.  DBS for dystonia, while an expensive treatment, compares favorably to therapies that are commonly used for other conditions.
authors.affiliation: Department of Neurosurgery, Radcliffe Infirmary, Woodstock Road, Oxford, UK;              University of Oxford, Institute of Health Sciences, UK;              Charing Cross Hospital, Fulham Palace Road, London, UK; and              Australasian Movement Disorder and Pain Surgery Clinic, Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Yianni
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Green
authors.forename: Emma
authors.initials: E
authors.lastname: McIntosh
authors.forename: Richard G
authors.initials: RG
authors.lastname: Bittar
authors.forename: Carol
authors.initials: C
authors.lastname: Joint
authors.forename: Richard
authors.initials: R
authors.lastname: Scott
authors.forename: Ralph
authors.initials: R
authors.lastname: Gregory
authors.forename: Peter G
authors.initials: PG
authors.lastname: Bain
authors.forename: Tipu Z
authors.initials: TZ
authors.lastname: Aziz