Abstract
Background
Parkinson's disease (PD) is the second most prevalent neurodegenerative 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.
Keywords
Parkinson Disease - Levodopa - Deep Brain Stimulation - Cost-Effectiveness Analysis
- Cost-Benefit Analysis
Bibliographical Record
Carlos Zúñiga-Ramírez, Katia Carmina Farías-Moreno, Gabriel Moreno, Enrique Gómez-Figueroa,
Hernando Efraín Caicedo-Ortíz, José Damián Carrillo-Ruíz. The costs and benefits of
deep brain stimulation in Parkinson's disease: a review and social network analysis.
Arq Neuropsiquiatr 2025; 83: s00451809996.
DOI: 10.1055/s-0045-1809996
