使用日本医疗保险索赔国家数据库对脑深部电刺激进行成本最小化分析。
Cost-Minimization Analysis of Deep-Brain Stimulation Using National Database of Japanese Health Insurance Claims.
作者信息
Akazawa Manabu, Konomura Keiko, Shiroiwa Takeru
机构信息
Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan.
Department of Health and Welfare Service, National Institution of Public Health, Wako, Saitama, Japan.
出版信息
Neuromodulation. 2018 Aug;21(6):548-552. doi: 10.1111/ner.12782. Epub 2018 Apr 26.
OBJECTIVES
A new rechargeable dual-channel deep brain stimulation (DBS) system has been introduced for the treatment of Parkinson's disease and other movement disorders. However, the clinical value of the device, which has a high cost, remains unclear.
MATERIALS AND METHODS
We conducted a cost-minimization analysis using a national database of health insurance claims in Japan. DBS-related costs were compared between rechargeable and non-rechargeable devices and estimated across a 20-year period.
RESULTS
Although the price of rechargeable DBS was higher than that of non-rechargeable DBS, we observed total cost-savings of 8.4 million yen across 20 years by considering costs related to implantation surgery, frequency of replacement, and risk of complications.
CONCLUSIONS
In this study, real-world evidence indicated that rechargeable dual-channel DBS is a reasonable choice for saving total medical costs. Price revisions should consider cost-effectiveness findings for medical devices.
目的
一种新型可充电双通道脑深部电刺激（DBS）系统已被引入用于治疗帕金森病和其他运动障碍。然而，这种成本高昂的设备的临床价值仍不明确。
材料与方法
我们利用日本全国健康保险索赔数据库进行了成本最小化分析。比较了可充电和不可充电设备的DBS相关成本，并在20年期间进行了估算。
结果
尽管可充电DBS的价格高于不可充电DBS，但通过考虑植入手术相关成本、更换频率和并发症风险，我们发现在20年期间总成本节省了840万日元。
结论
在本研究中，真实世界证据表明可充电双通道DBS是节省总医疗成本的合理选择。医疗器械的价格调整应考虑成本效益研究结果。
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