Cost-Effective Treatment Option for Tremor-Dominant Parkinson Disease

Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is more cost-effective than continued medical therapy for patients with tremor-dominant Parkinson disease, according to a cost-effectiveness analysis published online in the Journal of Neurosurgery. 

“The development of transcranial MRgFUS has revitalized the practice of lesioning procedures in functional neurosurgery,” researchers wrote. “Previous health economic analysis found MRgFUS thalamotomy to be a cost-effective treatment for patients with essential tremor, supporting its reimbursement.” 

Prompted by the publication of evidence supporting MRgFUS thalamotomy for patients with tremor-dominant Parkinson's disease, researchers looked at costs associated with MRgFUS, deep brain stimulation, and medical therapy.  

According to the analysis, MRgFUS was linked with $14,831 in expected costs in Canadian dollars. The incremental cost-effectiveness ratio of adding MRgFUS to continued medical therapy was a cost-effective $30,078 per quality-adjusted life year.

MRgFUS was competitive with deep brain stimulation, according to the study, but with a less substantial cost-effectiveness advantage. 

“Comparing deep brain stimulation to MRgFUS, while deep brain stimulation did not achieve the willingness-to-pay threshold ($56,503 per quality-adjusted life year) in the base-case scenario, it did so under several scenarios in the sensitivity analysis,” researchers reported. 

—Jolynn Tumolo 

Reference: 

Meng Y, Pople CB, Kalia SK, et al. Cost-effectiveness analysis of MR-guided focused ultrasound thalamotomy for tremor-dominant Parkinson's disease [published online ahead of print, 2020 Aug 7]. J Neurosurg. 2020;1-6. doi:10.3171/2020.5.JNS20692