Budget impact analysis of deep brain stimulation devices with different longevity in Parkinson's disease: insights from real-world data

Background: Deep brain stimulation (DBS) is a viable treatment option for Parkinson's disease (PD) based on modulation of brain networks by electrical stimulation powered by implantable pulse generators (IPGs). Commercially available IPGs are either rechargeable (R) or non-rechargeable (NR). A budget impact analysis was developed to compare costs of the two options in PD-DBS patients, focusing on avoided battery replacements, associated complications, hospitalization rates. Methods: The study was conducted in two phases: an observational, single-center, retrospective analysis from 2005 to 2023 of 94 PD-DBS patients, followed by a second phase in which the economic data obtained were used to build a budget impact analysis (BIA) comparing the two different options. Results: Data from 47 PD-DBS patients with NR and 47 with R-IPGs were examined. BIA was calculated on a single patient with a 15-year and 25-year R-IPG. The higher initial cost of R devices compared with NR devices is offset by the absence of device replacements. This results in an estimated savings of €38,333 per patient with a 15-year R-IPG and €71,584 with a 25-year IPG. Conclusions: BIA predicts that the cost savings with a long-lasting R-IPG up to 25 years is cost effective compared with NR, regardless of age and life expectancy.