Cost-utility analysis of Parkinson's disease.

Many expensive treatments have been developed for Parkinson's disease (PD), and a good cost-utility analysis is required. Quality-adjusted life-years (QALY) allows comparison of the cost-utility of different medical conditions. If a treatment strategy gives a patient an extra but unhealthy year, the QALY he obtained will be less than one. When a therapeutic strategy is more effective, but causes higher costs, it is mandatory to calculate the incremental cost-effectiveness ratio (ICER). In keeping with guidance from the UK National Institute for Health and Clinical Excellence (NICE), a therapy that deliver QALYs of £20,000 or less are likely to be approved. The threshold used by NICE for the maximum it is prepared to pay for a QALY, which lies between £20,000 and £30,000, will be reviewed case by case. Subthalamic deep brain stimulation (STN-DBS) is an effective therapy, which can improve the quality of life in PD patients immediately, but has not been approved by the Bureau of National Health Insurance here. It has been estimated that the ICER/QALY in STN-DBS patients was of 34,389C= , which is within appropriate limits to consider STNDBS as an efficient therapy. We expect that we can have a decision-making mechanism similar to that of NICE that, according to the ICER of each medical condition, medical resource can be redistributed openly and justly.