----- Original Message -----
From: William Harshaw <[log in to unmask]>
To: Parkinson's Information Exchange <[log in to unmask]>
Sent: Tuesday, July 18, 2000 8:34 PM
Subject: Economic Evaluation of DBS


> Dear Group,
>
> As some of you know, for a long time I have been keen to evaluate
> neurosurgery for Parkinson's from an economics viewpoint.  I have just
> completed a preliminary analysis and will share the results with you.
>
> 1.    This was a single patient study, or as the medical research analysts
> would say "a non-randomized group, n=1".   I am the single patient.
>
> 2.    Three alternatives were considered: (1) no neurosurgical
intervention;
> (2)neurosurgical intervention by pallidotomy; and (3) neurosurgical
> intervention by DBS.
>
> 3.    The study period was 1995-99.  The no intervention case assumed: my
> med bill carried forward from 1993 to the study period; admission to long
> term care facility by July/95; and accurate calculation of all costs.  The
> pallidotomy case assumed: my meds bill for 1994 caried orward to the study
> period; admission to long term care facility by July /95.  The DBS case
> assumes: DBS performed Dec/94 & actual med& stimulator operating costs.
>
> 4.    THe total cost of the: no intervention case $C$164,142; the
> pallidotomy case C$152,487; and the DBS case C$70,553
>
> 5.    I conclude, on the basis of the assumptions made, that DBS is not
only
> the most effective therapy; it is also the most cost effective of the
three
> considered
>
>         It must be emphasised that these results are preliminary and
subject
> to change.
>
>         Also the study has all the limitations of a single patient study,
> including: the extent to which the study patient is typical of the
> population; his drug tolerance; ... the list could go on.
>
>        Ii will gladly send a copy of the completed report whenit is ready,
> in about a month.  I thought list members would like to know these early
> results.
>
>         Comments welcome!
>
>
>
>
>