Cost-Minimization Analysis of Deep-Brain Stimulation Using National Database of Japanese Health Insurance Claims

Neuromodulation. 2018 Aug;21(6):548-552. doi: 10.1111/ner.12782. Epub 2018 Apr 26.

Abstract

Objectives: A new rechargeable dual-channel deep brain stimulation (DBS) system has been introduced for the treatment of Parkinson's disease and other movement disorders. However, the clinical value of the device, which has a high cost, remains unclear.

Materials and methods: We conducted a cost-minimization analysis using a national database of health insurance claims in Japan. DBS-related costs were compared between rechargeable and non-rechargeable devices and estimated across a 20-year period.

Results: Although the price of rechargeable DBS was higher than that of non-rechargeable DBS, we observed total cost-savings of 8.4 million yen across 20 years by considering costs related to implantation surgery, frequency of replacement, and risk of complications.

Conclusions: In this study, real-world evidence indicated that rechargeable dual-channel DBS is a reasonable choice for saving total medical costs. Price revisions should consider cost-effectiveness findings for medical devices.

Keywords: Cost-minimization analysis; deep brain stimulation; health technology assessment; national insurance claims.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Deep Brain Stimulation / economics*
  • Deep Brain Stimulation / instrumentation
  • Deep Brain Stimulation / methods*
  • Electric Power Supplies / economics
  • Electrodes, Implanted
  • Female
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Insurance Claim Reporting / statistics & numerical data
  • Insurance, Health*
  • Japan
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parkinson Disease / economics*
  • Parkinson Disease / therapy*
  • Time Factors