OBJECTIVES: Deep brain stimulation (DBS) is an established treatment option for movement disorders such as Parkinson’s disease (PD) and dystonia that do not respond well to medication. Rechargeable DBS devices are available, reducing the frequency of battery replacements. This analysis compared the costs of DBS in PD and dystonia patients via non-rechargeable (PC) and rechargeable (RC) DBS devices, in Denmark, Sweden and Norway.

METHODS: A Markov model was developed to simulate costs of device acquisition, implantation and replacement, and adverse events, for PD and dystonia patients. Registry data were used to model PC device replacements and adverse events. Unit costs for each country were combined with mortality data and length of stay information. Scenarios were modelled with the former 9-year and new 15-year guaranteed longevity for the RC device; a 16-year horizon was used to capture one RC replacement. A payer perspective was applied; costs were discounted according to country-specific recommendations.

RESULTS: With a 15-year longevity, RC devices reduced costs by 51% (Denmark), 45% (Norway) and 44% (Sweden) among PD patients, compared with PC devices, over 16 years. Cost savings for RC versus PC were even higher for dystonia patients: 59% (Denmark), 55% (Norway) and 53% (Sweden). Savings were greater with the 15-year longevity compared with 9-year longevity. RC devices became cost-saving within 5 years and avoided up to 21 hospital days per patient over the model horizon.

CONCLUSIONS: Rechargeable devices are projected to save money over non-rechargeable devices through the reduction in battery replacements. Patients are projected to spend fewer days in hospital and have fewer adverse events. RC devices become cost-saving around the time of first PC device replacement; cost savings are particularly significant among dystonia patients, reflecting the greater energy needs for DBS. The use of RC devices can therefore improve the cost-effectiveness profile of DBS.