Incremental cost-effectiveness ratios for Parkinson’s disease patients comparing advanced therapies to best medical treatment
Katarzyna Smilowska PhD, Tomasz Pietrzykowski PhD, Alexander Calvano, K Ray Chaudhuri DSc, Daniel J van Wamelen PhD
The advanced stage of Parkinson’s disease (PD) manifests with progressively increasing disabilities. These usually present as fluctuations between akinetic periods (off phenomenon) and mobile periods (on phenomenon) with or without dyskinesia. At this stage of the disease, treatment aims should shift from oral medication to more continuous dopaminergic stimulation in the form of device-aided therapies, not in the least as these therapies also have a positive effect on many non-motor symptoms, and thus improve quality of life for PD patients. Currently available device-aided therapies are Deep brain stimulation (DBS), intrajejunal Levodopa-carbidopa infusion (IJLI) and continuous subcutaneous apomorphine infusion (CSAI). Here, we aimed to perform a systematic review of the available literature on economic analyses of device-aided therapies in patients with PD in order to assess the cost-effectiveness of these therapies.