title: Cost of deep brain stimulation for the treatment of Parkinson's disease by surgical stimulation sites.
abstract: OBJECTIVE
  To assess costs and effectiveness of deep brain stimulation (DBS) of the internal globus pallidum (GPi) versus subthalamic nucleus (STN) from the provider and societal perspectives for Parkinson's disease (PD) patients in a multicenter randomized trial.
  
  
  METHODS
  All costs from randomization to 36 months were included. Costs were from Department of Veterans Affairs (VA) and Medicare databases and clinical trial data. Quality adjusted life years (QALYs) were from Quality of Well Being questionnaires.
  
  
  RESULTS
  Provider costs were similar for the 144 GPi and 130 STN patients (GPi: $138,044 vs. STN: $131,822; difference = $6,222, 95% confidence interval [CI]: -$42,125 to $45,343). Societal costs were also similar (GPi: $171,061 vs. STN: $167,706; difference = $3,356, 95% CI: -$57,371 to $60,294). The GPi patients had nonsignificantly more QALYs.
  
  
  CONCLUSIONS
  The QALYs and costs were similar; the level of uncertainty given the sample size suggests that these factors should not direct treatment or resource allocation decisions in selecting or making available either procedure for eligible PD patients.
authors.affiliation: Hines VA Hospital, Center for Management of Complex Chronic Healthcare, Hines, Illinois, USA; Loyola University Stritch School of Medicine, Maywood, Illinois, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Lishan
authors.initials: L
authors.lastname: Cao
authors.forename: Dolores
authors.initials: D
authors.lastname: Ippolito
authors.forename: Brandon R
authors.initials: BR
authors.lastname: Barton
authors.forename: Inger E
authors.initials: IE
authors.lastname: Burnett-Zeigler
authors.forename: Robert G
authors.initials: RG
authors.lastname: Holloway
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Vickrey
authors.forename: Tanya
authors.initials: T
authors.lastname: Simuni
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Follett
mesh_terms: D003362:Cost-Benefit Analysis; D046690:Deep Brain Stimulation / Q000191:economics* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000502:physiology; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare; D010300:Parkinson Disease / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D020531:Subthalamic Nucleus / Q000502:physiology; D011795:Surveys and Questionnaires; D014481:United States
keywords: Parkinson's disease; cost; deep brain stimulation