MR-guided focused ultrasound versus DBS therapy for the treatment of tremor-dominant Parkinson’s disease or essential tremor. An analysis on clinical efficacy, safety and cost-effectiveness
EANS Academy. Giammalva G. 10/04/21; 339352; EP08007
Dr. Giuseppe Roberto Giammalva
Contributions
Contributions
Abstract
Backgroundː Essential Tremor and Parkinson Disease are the most common movement disorders. Tremor is not strictly dangerous, but it can cause significant disability and reduction of the quality of life. These conditions may be diagnosed and treated at their early stages, despite sometimes being refractory to medical management. In these patients, deep brain stimulation therapy and the emerging magnetic resonance-guided focused ultrasound surgery are viable treatments.
Methodsː At our Institutions, we retrospectively identified two cohort of patients undergoing deep brain stimulation implant or ultrasound thalamotomy for the treatment of tremor-dominant Parkinson’s disease or essential tremor. Mean operative times and estimated cost were calculated in relation to the Italian setting, according to data released by the Italian Ministry of Health.
Resultsː The mean bilateral deep brain stimulation therapy cost is €20.721,684 per procedure. For ultrasound thalamotomy, the total cost of a single treatment is € 6.294,5 which makes this procedure about 70% less expensive. Outcomes in terms of complications and follow-up were analyzed as well.
Conclusionː Ultrasound thalamotomy has resulted 70% less expensive than deep brain stimulation therapy. Both the economic impact of complications and the cost of the procedure for single patient are more relevant for deep brain stimulation therapy, despite ultrasound thalamotomy requires a huger initial investment to acquire the technological devices. Further studies and longer follow-up will assess how to offer the best treatment solutions in term of cost-effectiveness to these patients.
Methodsː At our Institutions, we retrospectively identified two cohort of patients undergoing deep brain stimulation implant or ultrasound thalamotomy for the treatment of tremor-dominant Parkinson’s disease or essential tremor. Mean operative times and estimated cost were calculated in relation to the Italian setting, according to data released by the Italian Ministry of Health.
Resultsː The mean bilateral deep brain stimulation therapy cost is €20.721,684 per procedure. For ultrasound thalamotomy, the total cost of a single treatment is € 6.294,5 which makes this procedure about 70% less expensive. Outcomes in terms of complications and follow-up were analyzed as well.
Conclusionː Ultrasound thalamotomy has resulted 70% less expensive than deep brain stimulation therapy. Both the economic impact of complications and the cost of the procedure for single patient are more relevant for deep brain stimulation therapy, despite ultrasound thalamotomy requires a huger initial investment to acquire the technological devices. Further studies and longer follow-up will assess how to offer the best treatment solutions in term of cost-effectiveness to these patients.
Backgroundː Essential Tremor and Parkinson Disease are the most common movement disorders. Tremor is not strictly dangerous, but it can cause significant disability and reduction of the quality of life. These conditions may be diagnosed and treated at their early stages, despite sometimes being refractory to medical management. In these patients, deep brain stimulation therapy and the emerging magnetic resonance-guided focused ultrasound surgery are viable treatments.
Methodsː At our Institutions, we retrospectively identified two cohort of patients undergoing deep brain stimulation implant or ultrasound thalamotomy for the treatment of tremor-dominant Parkinson’s disease or essential tremor. Mean operative times and estimated cost were calculated in relation to the Italian setting, according to data released by the Italian Ministry of Health.
Resultsː The mean bilateral deep brain stimulation therapy cost is €20.721,684 per procedure. For ultrasound thalamotomy, the total cost of a single treatment is € 6.294,5 which makes this procedure about 70% less expensive. Outcomes in terms of complications and follow-up were analyzed as well.
Conclusionː Ultrasound thalamotomy has resulted 70% less expensive than deep brain stimulation therapy. Both the economic impact of complications and the cost of the procedure for single patient are more relevant for deep brain stimulation therapy, despite ultrasound thalamotomy requires a huger initial investment to acquire the technological devices. Further studies and longer follow-up will assess how to offer the best treatment solutions in term of cost-effectiveness to these patients.
Methodsː At our Institutions, we retrospectively identified two cohort of patients undergoing deep brain stimulation implant or ultrasound thalamotomy for the treatment of tremor-dominant Parkinson’s disease or essential tremor. Mean operative times and estimated cost were calculated in relation to the Italian setting, according to data released by the Italian Ministry of Health.
Resultsː The mean bilateral deep brain stimulation therapy cost is €20.721,684 per procedure. For ultrasound thalamotomy, the total cost of a single treatment is € 6.294,5 which makes this procedure about 70% less expensive. Outcomes in terms of complications and follow-up were analyzed as well.
Conclusionː Ultrasound thalamotomy has resulted 70% less expensive than deep brain stimulation therapy. Both the economic impact of complications and the cost of the procedure for single patient are more relevant for deep brain stimulation therapy, despite ultrasound thalamotomy requires a huger initial investment to acquire the technological devices. Further studies and longer follow-up will assess how to offer the best treatment solutions in term of cost-effectiveness to these patients.
{{ help_message }}
{{filter}}