Deep Brain Stimulation for Advanced Parkinson Disease in Developing Countries: A Cost-Effectiveness Study From China

Area of Science:

• Neurology
• Health Economics

Background:

• Deep brain stimulation (DBS) is recognized as cost-effective for advanced Parkinson disease (PD) in developed nations.
• The cost-effectiveness of DBS in developing countries, particularly concerning healthcare reimbursement, remains under-explored.

Purpose of the Study:

• To model and assess the long-term cost-effectiveness of DBS compared to best medical treatment (BMT) for advanced PD in China.
• To analyze the economic impact from a patient-payer perspective.

Main Methods:

• A 15-year time horizon Markov model was developed to simulate PD progression and associated costs.
• Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and net benefit analysis.

Main Results:

• DBS yielded an additional 1.51 quality-adjusted life years (QALYs) at an ICER of ¥213,544 ($32,549.96) per QALY.
• Sensitivity analysis indicated DBS costs significantly influence the ICER.
• Favorable cost-effectiveness for DBS was linked to younger patient age and earlier disease stages.

Conclusions:

• DBS is a cost-effective intervention for advanced PD in China over 15 years.
• Despite cost-effectiveness, DBS presents a substantial economic challenge for Chinese patients without reimbursement.
• Findings can inform healthcare policy for PD management in developing economies.