Table 36:
Deterministic Scenario Analysis Results—MRgFUS Neurosurgery vs. Radiofrequency Thalamotomy or Deep Brain Stimulation
| MRgFUS vs. RF | DBS vs. MRgFUS | |||||
|---|---|---|---|---|---|---|
| Incremental Cost | Incremental QALYs | ICER | Incremental Cost | Incremental QALYs | ICER | |
| Reference case | $8,530 | 0.08 | $109,795 | $34,028 | 0.25 | $134,259 |
| Societal perspective | $7,948 | 0.08 | $102,305 | $35,815 | 0.25 | $141,310 |
| Time horizon | ||||||
| 1 year | $7,980 | 0.01 | $546,289 | $19,996 | 0.07 | $297,776 |
| 10 years | $8,925 | 0.14 | $63,579 | $45,855 | 0.51 | $90,486 |
| Including capital cost of MRgFUS | $29,428 | 0.08 | $378,806 | $13,129 | 0.25 | $51,803 |
| Reducing post-surgery recovery cost of MRgFUS | $4,178 | 0.08 | $53,775 | $38,380 | 0.25 | $151,430 |
| Reducing MRI scan cost for all surgeries | $8,530 | 0.08 | $109,795 | $33,886 | 0.25 | $133,702 |
| Utility of mild to moderate improvement post-surgery (0.71, based on Herceg et al, 201283) | $8,530 | 0.07 | $115,288 | $34,028 | 0.23 | $145,485 |
| Probability of recurrence in year 1 for MRgFUS and RF (11%, based on Zaaroor et al, 201745) | $8,541 | 0.08 | $110,090 | $33,998 | 0.26 | $131,715 |
| Probability of recurrence over 5 years for MRgFUS (50%, based on expert opinion) | $10,211 | 0.02 | $410,779 | $32,346 | 0.31 | $105,612 |
| Surgical effectiveness (based on Kim et al, 201746) | $8,554 | 0.04 | $196,484 | $34,023 | 0.26 | $128,867 |
Abbreviations: DBS, deep brain stimulation; ICER, incremental cost-effectiveness ratio; MRgFUS, magnetic resonance-guided focused ultrasound; RF, radiofrequency; QALY, quality-adjusted life year.