Abstract
Background Parkinson’s disease (PD) is the second most prevalent neurodegenera-tive disorder worldwide. Levodopa has been considered the best treatment option.
However, deep brain stimulation (DBS) use has increased over time, mostly when levodopa-related complications arise.
Objective To review the current evidence regarding economic evaluations assessing costs and benefits comparing pharmacological versus surgical treatment among subjects with PD.
Methods We searched three databases (PubMed, Embase, and Google Scholar) for studies comparing levodopa treatment and DBS among subjects with PD in terms of costs and benefits from therapy.
Results Out of the 107 studies identified, 14 met the inclusion criteria. Most of the published studies were from Europe. Incremental cost-effectiveness ratios have shown variable results, from -€979 to €6,729 per change of 1 point in the score on part III of the Unified Parkinson’s Disease Rating Scale (UPDRS III), while incremental cost-utility ratios depict values as low as €6,700 and as high as $704,906.03 per quality-adjusted life-years (QALY).
Conclusion We observed a higher cost during the 1st year of DBS implantation due to the surgical procedure itself, subsequently, there was a trend for a lower cost over the following years, with no loss of benefit. Overall, the studies showed DBS as a cost-effective measure at 5-years after implantation.