Economic and clinical evaluation of vagus nerve stimulation therapy.
Author: Kopciuch D1, Barciszewska AM2,3, Fliciński J4, Paczkowska A1, Winczewska-Wiktor A4, Jankowski R2,3, Steinborn B4, Nowakowska E1
Affiliation:
1Department of Pharmacoeconomics and Social Pharmacy, Karol Marcinkowski University of Medical Sciences in Poznań, Poland.
2Department of Neurosurgery and Neurotraumatology, Karol Marcinkowski University of Medical Sciences in Poznań, Poland.
3Department of Neurosurgery and Neurotraumatology, Heliodor Swiecicki Clinical Hospital in Poznan, Poland.
4Department of Developmental Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Poland.
Conference/Journal: Acta Neurol Scand.
Date published: 2019 Jun 5
Other:
Special Notes: doi: 10.1111/ane.13137. [Epub ahead of print] , Word Count: 270
OBJECTIVES: The medical and social care of drug-resistant epilepsy (DRE) entails significant costs. Approximately 30 to 40 percent of patients with DRE who underwent vagus nerve stimulator (VNS) implantation achieve an above 50 percent reduction in seizure frequency. The study objective was to analyze the effect of VNS on clinical effects improvement and therapy cost reduction in patients with DRE over a 2-year follow-up period. The second purpose of the study was to compare average costs of VNS treatment of patients with DRE in selected countries, taking into account the purchasing power parity.
MATERIALS AND METHODS: The study included all the patients who had VNS implanted at our department between 2014-2018. Data on clinical events and medical costs were collected prospectively and obtained from medical documentation. We also reviewed relevant literature on costs of VNS therapy in patients with DRE from the last 18 years.
RESULTS: Resource utilization and epilepsy-related events were reduced during the follow-up period compared to the baseline. Average total cost was estimated at EUR 7,703.59 in year 1 and at EUR 7,108.38 in year 2 following VNS implantation. Average direct costs of VNS treatment of patients with DRE over the last 18 years varied between the countries and ranged from EUR 24,790.43 in the USA to EUR 64.84 in the United Kingdom.
CONCLUSION: VNS is a cost-effective therapy yielding measurable clinical and therapeutic outcomes over the long term. Moreover, the analysis contained in this review highlights the poor consensus of methodological approaches. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS: costs; drug-resistant epilepsy; economic and clinical evaluation; international comparison; vagus nerve stimulation therapy
PMID: 31165476 DOI: 10.1111/ane.13137
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