Table 20:

Costs of Managing Adverse Event Hospitalizations

Adverse event	Reference case, $a	Plausible range minimum, $a	Plausible range maximum, $a	Treatment assumptions	Source(s)
MRgFUS neurosurgery
No adverse events reported	N/A	N/A	N/A		Clinical review
Average total per-person cost of managing adverse events	0.00	0.00	0.00
RFA
Infection	32.39	0.00	98.72	10% of patients require hospitalization; the remaining 90% of patients are treated with antibiotics as outpatientsb	CIHI patient cost estimator114; IntelliHealth Ontario1; Montoya et al, 2002113; Sheth et al, 2013108
Cerebral hemorrhage	256.05	0.00	256.05	22% (8/37) of cases are symptomatic116 and are hospitalized for close monitoring and blood pressure controlb	CIHI patient cost estimator114; Gong et al, 2018107; Horisawa et al, 2021116; IntelliHealth Ontarioc; Liu et al, 2008105; Liu et al, 2017104; Zhan et al, 2014106
Average total per-person cost of managing adverse events	288.44	0.00	354.77
Gamma Knife radiosurgery
Brain cyst	302.39	60.48	302.39	33% of cysts are symptomatic,109 require hospitalization, and are managed with inpatient observationb	CIHI patient cost estimator114; Gupta et al, 2019110; IntelliHealth Ontarioc; Lopes et al, 20 1433; Peker et al, 2020111; Rasmussen et al, 2018109
Perilesional edema	897.15	0.00	897.15	50% of patients are treated in the hospitalb	CIHI patient cost estimator114; Gupta et al, 2019110; IntelliHealth Ontarioc; Lopes et al, 20 1433; Peker et al, 2020111; Rasmussen et al, 2018109
Average total per-person cost of managing adverse events	1,199.53	60.48	1,199.53
DBS
Infection (surgically treated)	414.61	N/A	N/A	All surgically treated infections are managed in the hospital	CIHI patient cost estimator114; Gadot et al, 2022112; IntelliHealth Ontarioc
Hardware malfunction	2,979.57	N/A	N/A	All hardware malfunctions require a reoperation117	Fenoy and Simpson, 2014117; Gadot et al, 2022112
Seizure (generalized tonic-clonic)	161.91	N/A	N/A	All seizure disorders require 1 hospitalization	CIHI patient cost estimator114; Gadot et al, 2022112
Cerebral hemorrhage (with sequalae)	114.83	N/A	N/A	All cerebral hemorrhage with sequalae require hospitalization	CIHI patient cost estimator114; Gadot et al, 2022112; IntelliHealth Ontarioc
Average total per-person cost of managing adverse events	3,670.94	N/A	N/A

Note: Numbers may be inexact due to rounding.

Abbreviations: CIHI, Canadian Institute for Health Information; DBS, deep brain stimulation; MRgFUS, magnetic resonance-guided focused ultrasound; N/A, not applicable; RFA, radiofrequency ablation.

^aAll costs are reported in 2023 Canadian dollars.

^bB. Davidson, MD, email communication, November 8, 2023.

^cAccessed November 9, 2023.