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. 2018 May 3;18(4):1–141.

Table 21:

Results of Economic Literature Review—Summary

Author, Year, Location Study Design and Perspective Population Interventions Results
Health Outcome, QALYs (SD) Costs, 2017 USD (SD) Cost-Effectiveness
Ravikumar et al, 2017, United States54

  • Cost–utility analysis

  • Decision tree model

  • Time horizon: not reported but assumed to be less than 1 year based on the results

  • U.S. societal perspective

  • People with medication-refractory essential tremor

  • MRgFUS thalamotomy

  • Deep brain stimulation, unstaged

  • Deep brain stimulation, staged

  • Stereotactic radiosurgery

  • MRgFUS: 0.194 (0.005)

  • DBS, unstaged: 0.134 (0.003)

  • DBS, staged: 0.134 (0.003)

  • SRS: 0.116 (0.003)

  • MRgFUS: $20,593 (−1,402)

  • DBS, unstaged: $27,906 (−524)

  • DBS, staged: $45,107 (−614)

  • SRS: $20,013 (−1,036)

  • MRgFUS dominates DBS (more effective, less costly)

  • ICER, unstaged DBS vs. SRS: $483,500/QALY

  • ICER, staged DBS vs. SRS: $1,476,118/QALY (calculated based on results reported)

  • ICER, MRgFUS vs. SRS: $7,436/QALY (calculated based on results reported)

Abbreviations: DBS, deep brain stimulation; ICER, incremental cost-effectiveness ratio; MRgFUS, magnetic resonance-guided focused ultrasound; QALY, quality-adjusted life-year; SD, standard deviation (from probabilistic analysis); SRS, stereotactic radiosurgery.