Medical Student Vanderbilt University School of Medicine Nashville, Tennessee, United States
Introduction: Approximately 12,000 patients per year worldwide undergo deep brain stimulation (DBS) for treatment of movement disorders, epilepsy, pain and psychiatric disorders. With any commonly performed intervention, cost should be analyzed to determine overall resource utilization within the constraints of the healthcare environment in which it is performed. Our aim is to provide an economic evaluation of the reported DBS-related cost from published literature.
Methods: A systematic review of literature for cost of DBS was conducted in accordance with PRISMA guidelines. Studies from all countries were considered. Cost categories were separated into total treatment as defined by the study and total cost of the surgery, if available. Historical currency exchange rates provided by OANDA were used to convert to a common denominational currency for this study, in dollars. Cost was corrected for inflation to May 2022 using the Producer Price Index.
Results: Of 1,672 articles, 31 articles were included in the final analysis. Studies originated most commonly from the United States (11) and the United Kingdom (4). Article dates ranged from 2001-2021. Parkinson’s disease was the most commonly reported indication (19). Twenty-six studies reported treatment cost, which ranged from $4,918-$164,352 with an unweighted average of $51,804.27±$33,605.11. Eight studies reported the total cost of surgery, ranging from $20,696-$68,423 with an unweighted average of $43,038.05±$15,581.43. One study reported a total cost of a two-stage procedure at $66,788.25. No studies utilized a cost or economic evaluation checklist or tool.
Conclusion : An initial literature-based cost analysis of DBS shows both a wide variability in the data as well as lack of standardization of cost reporting metrics. Further standardization and implementation of cost metrics is needed to optimize cost effectiveness of DBS.
