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Hans, That is fascinating The totat cost of my STN Surgery was 50-60,000 charged of course to my insurance company. And the hospital stay was 4 days. I presume that the surgeons are as good or better trained than our US Surgeons who are flocking to Europe to be trained in STN. The costs are what the traffic will bear and the US system with its 3rd party payment system will bear the most. How Medtronic can charge more than 2x the amount for the same instrument is beyond me . Not to mention the surgeons fees etc. Hans van der Genugten wrote: > Hi all, > > There were questions about the costs of replacing a battery/stimulator used > for DBS. > > Here is the answer I received from dr. Chris van der Linden, neurologist, > working in the hospital in Gent, Belgium. By the neurosurgeon in this > hospital a lot (45) of his patients were treated with DBS. > > ****************************************************** > > The replacement of the battery is very simple and can be done with local > anaesthesia. > So it can be done in a one day stay in hospital. > The battery/stimulator is usualy placed below the skin, just below the > collarbone. > This battery is connected with a wire under the skin to the electrode in the > brain. > The electrode, once it is implanted, never needs replacement (unless in very > rare and extreme cases in which the electrode is infected). > In Gent we had to replace more than 15 batteries since 1996. These were > batteries for pallidal stimulation, for which a much higher voltage is > needed than for subthalamic stimulation. > > A battery costs $4,750. So the patient in the USA pays to much (while these > stimulators are made in the USA). One day hospitalisation costs > approximately $350. > > The estimated total costs for replacing the battery of a USA patient are: > battery $ 4,750 > surgery $ 350 > hospitalisation $ 350 > planeticket (1 person) $ 500 > hotel (1 p./2 nights) $ 300 > > Total costs $ 6,250 > > If you want to be accompagnied by your caregiver (seems logical, because you > always can feel not very well after surgery and you may need someone you can > trust nearby): > Additional costs: > planeticket $ 500 > hotel (1 p./2 nights) $ 300 > > Total extra costs $ 800 > > Comparing the total costs in Belgium with the costs in the USA it is clear > that you are financially better off to have the replacement done in Belgium. > > As far as I can see there are no medical or technical risks or problems by > having it done in Belgium. > This is because replacing a battery in Belgium has become routine surgery. > > ***************************************************** > > Here ends the reaction of dr. Chris van der Linden. > > For those interested in the total costs of a bi-lateral DBS of the STN, in > Gent, Belgium, here is a estimate made by me. In individual cases these > costs can differ from this estimate, it's just to give you some idea: > Again for a patient from the USA: > > Battery Left $ 4,750 > Battery Right $ 4,750 > Extension wire L $ 290 > Extension wire R $ 290 > Electrode L $ 1,220 > Electrode R $ 1,220 > "remote control" $ 270 > Surgery $ 3,500 (10x $350?) > 14 days in hospital $ 4,900 > planeticket (1 person) $ 500 > hotel (1 p./2 nights) $ 300 > > Total costs: $ 21,990 > > Additional costs if you take a caregiver along: > planeticket $ 500 > hotel (1p./16 nights) $ 2,400 > (I presume staying with a belgian PWP could be a cheaper alternative). > > Hans. -- ****************************************************************************************** Charles T. Meyer, M.D. Middleton (Madison), Wisconsin [log in to unmask] ******************************************************************************************