OBJECTIVES: : Deep brain stimulation (DBS) use in dystonia is associated with high energy needs and as such frequent replacement of the device. The first rechargeable DBS device (Activa®RC) offers a guaranteed 9 years longevity. Our objective is to perform a cost analysis of Activa®RC compared to the non rechargeable neurostimulators in dystonia patients in France. METHODS: : A retrospective data collection was performed in a Neurosurgery Department (Pr. Ph. Coubes - Montpellier Public Hospital) with significant experience in DBS for dystonia. The cost analysis was based on direct medical costs, from a national insurance perspective. The evaluation concerns the device and hospitalization tariffs, the procedure cost being included in the hospitalization tariffs, in France, for the public hospitals. We compared the time to replacement with non-rechargeable devices versus rechargeable device, extrapolated over 9 years. A sensitivity analysis was performed using time-to-replacement variable. RESULTS: : The cohort included 63 consecutive dystonia patients, implanted with a non-rechargeable device (Kinetra™, Soletra™, Itrel®2) between 1996 and 2010. Overall, 117 implantations were performed (primo-implantation and replacement). The mediane time to replacement of the non-rechargeable devices was 2.9 years, ranging between 0.4 and 7.8 years. When extrapolated to the cohort population, the use of the rechargeable device would have avoided a total number of 215 hospitalizations over 9 years. The number of days of hospitalization avoided per patient was 10 days. The direct medical cost (device and hospitalization tariffs) avoided per patient was 27 886€. CONCLUSIONS: : Over 9 years, the rechargeable DBS device allows to avoid 2 device replacements per patient. This is associated with a 40 % reduction of the total number of days in hospital, and 43% reduction in the direct medical cost. The rechargeable neurostimulator Activa®RC is adapted to patients with high energy needs like dystonia patients, with a time to replacement of 5 years or less.