Internal Pulse Generators in Deep Brain Stimulation: Rechargeable or Not?

Michele Rizzi, Giuseppe Messina, Federica Penner, Antonio D'Ammando, Francesco Muratorio, Angelo Franzini

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective Deep brain stimulation (DBS) is a cost-effective strategy for the treatment of different neurologic disorders. However, DBS procedures are associated with high costs of implantation and replacement of the internal pulse generator (IPG). Different manufacturers propose the use of rechargeable IPGs. The objective of this study is to compare the implantation costs of nonrechargeable IPGs versus the estimated costs of rechargeable IPGs in different categories of patients to evaluate if an economic advantage for the health care system could be derived. Methods The study looked at 149 patients who underwent a surgical procedure for IPG replacement. In a hypothetical scenario, rechargeable IPGs were implanted instead of nonrechargeable IPGs at the time of DBS system implantation. Another scenario was outlined in a perspective period of time, corresponding to the patients' life expectancy. Costs were calculated, and inferential analysis was performed. Results A savings of €234,194, including the cost of management of complications, was calculated during a follow-up period of 7.9 years. In a comprehensive life expectancy period of 47 years, a savings of €5,918,188 would be obtained (P <0.05). Long-term group data point out that a relevant savings would be expected from implantation of rechargeable IPGs in dystonic patients (P <0.05) and patients with Parkinson disease (P <0.05), and a savings is projected to occur in other categories of patients (P <0.05). Conclusions Implantation of rechargeable IPGs presents clinical advantages compared with nonrechargeable devices. A huge economic savings can be realized with the implantation of rechargeable IPGs in categories of patients implanted with IPGs for DBS.

Original languageEnglish
Pages (from-to)1020-1029
Number of pages10
JournalWorld Neurosurgery
Volume84
Issue number4
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Deep Brain Stimulation
Costs and Cost Analysis
Life Expectancy
Economics
Nervous System Diseases
Parkinson Disease
Delivery of Health Care
Equipment and Supplies

Keywords

  • Cost-effective analysis
  • Deep brain stimulation
  • Hardware-related complications
  • Internal pulse generator
  • Rechargeable battery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

Internal Pulse Generators in Deep Brain Stimulation : Rechargeable or Not? / Rizzi, Michele; Messina, Giuseppe; Penner, Federica; D'Ammando, Antonio; Muratorio, Francesco; Franzini, Angelo.

In: World Neurosurgery, Vol. 84, No. 4, 01.10.2015, p. 1020-1029.

Research output: Contribution to journalArticle

Rizzi, Michele ; Messina, Giuseppe ; Penner, Federica ; D'Ammando, Antonio ; Muratorio, Francesco ; Franzini, Angelo. / Internal Pulse Generators in Deep Brain Stimulation : Rechargeable or Not?. In: World Neurosurgery. 2015 ; Vol. 84, No. 4. pp. 1020-1029.
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abstract = "Objective Deep brain stimulation (DBS) is a cost-effective strategy for the treatment of different neurologic disorders. However, DBS procedures are associated with high costs of implantation and replacement of the internal pulse generator (IPG). Different manufacturers propose the use of rechargeable IPGs. The objective of this study is to compare the implantation costs of nonrechargeable IPGs versus the estimated costs of rechargeable IPGs in different categories of patients to evaluate if an economic advantage for the health care system could be derived. Methods The study looked at 149 patients who underwent a surgical procedure for IPG replacement. In a hypothetical scenario, rechargeable IPGs were implanted instead of nonrechargeable IPGs at the time of DBS system implantation. Another scenario was outlined in a perspective period of time, corresponding to the patients' life expectancy. Costs were calculated, and inferential analysis was performed. Results A savings of €234,194, including the cost of management of complications, was calculated during a follow-up period of 7.9 years. In a comprehensive life expectancy period of 47 years, a savings of €5,918,188 would be obtained (P <0.05). Long-term group data point out that a relevant savings would be expected from implantation of rechargeable IPGs in dystonic patients (P <0.05) and patients with Parkinson disease (P <0.05), and a savings is projected to occur in other categories of patients (P <0.05). Conclusions Implantation of rechargeable IPGs presents clinical advantages compared with nonrechargeable devices. A huge economic savings can be realized with the implantation of rechargeable IPGs in categories of patients implanted with IPGs for DBS.",
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AB - Objective Deep brain stimulation (DBS) is a cost-effective strategy for the treatment of different neurologic disorders. However, DBS procedures are associated with high costs of implantation and replacement of the internal pulse generator (IPG). Different manufacturers propose the use of rechargeable IPGs. The objective of this study is to compare the implantation costs of nonrechargeable IPGs versus the estimated costs of rechargeable IPGs in different categories of patients to evaluate if an economic advantage for the health care system could be derived. Methods The study looked at 149 patients who underwent a surgical procedure for IPG replacement. In a hypothetical scenario, rechargeable IPGs were implanted instead of nonrechargeable IPGs at the time of DBS system implantation. Another scenario was outlined in a perspective period of time, corresponding to the patients' life expectancy. Costs were calculated, and inferential analysis was performed. Results A savings of €234,194, including the cost of management of complications, was calculated during a follow-up period of 7.9 years. In a comprehensive life expectancy period of 47 years, a savings of €5,918,188 would be obtained (P <0.05). Long-term group data point out that a relevant savings would be expected from implantation of rechargeable IPGs in dystonic patients (P <0.05) and patients with Parkinson disease (P <0.05), and a savings is projected to occur in other categories of patients (P <0.05). Conclusions Implantation of rechargeable IPGs presents clinical advantages compared with nonrechargeable devices. A huge economic savings can be realized with the implantation of rechargeable IPGs in categories of patients implanted with IPGs for DBS.

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