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Journal of Neurology

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01-08-2020 | Antidepressant Drugs | Original Communication

Longitudinal medication profile and cost savings in Parkinson’s disease patients after bilateral subthalamic nucleus deep brain stimulation

Authors: Jing Han Ng, Angela An Qi See, Zheyu Xu, Nicolas Kon Kam King

Published in: Journal of Neurology | Issue 8/2020

Abstract

Introduction

Deep brain stimulation of the subthalamic nucleus (STN DBS) has been shown to reduce antiparkinsonian medication in Parkinson’s disease. We aimed to investigate the changes in long-term medication profile with STN DBS.

Methods

Antiparkinsonian medication data for 56 patients were collected from as early as 3 years before STN DBS up to 10 years after. Cost spending on medication changes was analyzed. Mean levodopa equivalent daily dose (LEDD) was projected 10 years into the future based on preoperative data to create a comparator group wherein the patients did not undergo STN DBS. Use of neuroleptics and antidepressants was also recorded.

Results

LEDD requirement was significantly reduced by a mean of 31 ± 2% over 10 years after DBS, from 1049 ± 381 mg at pre-DBS baseline, to 713 ± 392 mg at 1 year post-DBS, and 712 ± 385 mg at 10 years post-DBS. This was associated with a mean reduction of 35 ± 3% in medicine cost. Modeled LEDD requirements for not having STN DBS were in the range of 1489 mg to 2721 mg at 10 years post-DBS (109–282% higher than the observed mean LEDD in DBS cohort). The proportion of patients increased from 5% before STN DBS to 14% at 10 year post-DBS for neuroleptics, and 11–23% for antidepressants.

Conclusion

STN DBS led to LEDD reduction and antiparkinsonian medication cost savings in our South-East Asian cohort. Medication reduction with STN DBS in our cohort over the 10-year period was comparable to those reported in Western populations.

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Title: Longitudinal medication profile and cost savings in Parkinson’s disease patients after bilateral subthalamic nucleus deep brain stimulation
Authors: Jing Han Ng
Angela An Qi See
Zheyu Xu
Nicolas Kon Kam King
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Antidepressant Drugs
Deep Brain Stimulation
Parkinson's Disease
Antidepressant Drugs
Levodopa
Published in: Journal of Neurology / Issue 8/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09741-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Longitudinal medication profile and cost savings in Parkinson’s disease patients after bilateral subthalamic nucleus deep brain stimulation

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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