科研之友
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摘要
Background: Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder with a 2% to 3% lifetime prevalence; in addition, 10% of OCD patients are resistant to conventional therapy. Deep brain stimulation (DBS) has been an effective treatment for treatment resistant OCD patients (TROCD). We aimed to determine the cost-effectiveness of DBS for TROCD. Methods: We used a Markov model to estimate the cost-effectiveness of DBS compared to conventional treatment for TROCD with a 10-year time horizon. Published data were used to estimate the rates of treatment response and complications. Costs were calculated from the perspective of the third-party payer. Data on quality of life were obtained from a literature review and a survey of OCD patients. We applied the model separately to Korea and the United Kingdom (UK) to enhance the validity. Results: Base-case analysis showed an incremental cost-effectiveness ratio of US$37,865 per quality-adjusted life-year in Korea and US$34,462 per quality-adjusted life-year in the UK. According to the World Health Organization's criteria, DBS for TROCD was "cost-effective" in Korea (< 3x GDP per capita) and "highly cost-effective" in the UK (< GDP per capita). One-way sensitivity analysis showed consistent cost-effectiveness results for most variables with the exception of short-term duration of treatment effect (< 4 years in Korea; < 3 years in the UK). Conclusion: The results showed that DBS is a cost-effective treatment for TROCD in both the countries. Our findings provide economic evidence on the applicability of DBS for patients, health care service providers, and payers
- 出版日期2017-7
