Evidence map›Paper›PMID 33386813›Full record

SynthesisJournal of Parkinson's disease2021

Cost-Effectiveness of Device-Aided Therapies in Parkinson's Disease: A Structured Review.

Katarzyna Smilowska, Daniel J van Wamelen, Tomasz Pietrzykowski, Alexander Calvano, Carmen Rodriguez-Blazquez, Pablo Martinez-Martin, Per Odin, K Ray Chaudhuri

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of Parkinson's disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Refractory Motor Complications: Towards a Pragmatic Definition.Movement disorders clinical practice · 2026
    Article
  5. Review
  6. Article
  7. Advanced Therapeutics in Parkinson's Disease: What's New?Current neurology and neuroscience reports · 2026
    Review
  8. Review
  9. Review
  10. Observational
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 5 countries.

Katarzyna SmilowskaSilesian Center of Neurology, Katowice, Poland.
Daniel J van WamelenRadboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands.
Tomasz PietrzykowskiResearch Center for Public Policy and Regulatory Governance, Faculty of Law and Administration, University of Silesia, Katowice, Poland.
Alexander CalvanoInstitute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.
Carmen Rodriguez-BlazquezNational Center of Epidemiology and Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Pablo Martinez-MartinNational Center of Epidemiology and Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Per OdinUniversity of Lund, Faculty of Medicine, Lund, Sweden.
K Ray ChaudhuriInstitute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.
Biomedical Research Networking Center on Neurodegenerative Diseases · ESKing's College London · GBRadboud University Nijmegen · NLLund University · SEUniversity of Silesia in Katowice · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite optimal dopaminergic treatment most patients in moderate to advanced stages of Parkinson's disease (PD) experience progressively increasing disabilities, necessitating a shift from oral medication to device-aided therapies, including deep brain stimulation (DBS), intrajejunal levodopa-carbidopa infusion (IJLI), and continuous subcutaneous apomorphine infusion (CSAI). However, these therapies are costly, limiting their implementation.

objectivesTo perform a systematic review on cost-effectiveness analyses for device-aided therapies in PD.

methodsReferences were identified by performing a systematic search in the PubMed and Web of Science databases in accordance with the PRISMA statement. In the absence of universal cost-effectiveness definitions, the gross domestic product per capita (GDP) in the country where a study was performed was used as a cut-off for cost-effectiveness based on cost per quality adjusted life year (QALY) gained.

resultsIn total 30 studies were retrieved. All device-aided therapies improved quality of life compared to best medical treatment, with improvements in QALYs between 0.88 and 1.26 in the studies with long temporal horizons. For DBS, nearly all studies showed that cost per QALY was below the GDP threshold. For infusion therapies only three studies showed a cost per QALY below this threshold, with several studies with long temporal horizons showing costs below or near the GDP threshold.

conclusionOf the device-aided therapies, DBS can be considered cost-effective, but the majority of infusion therapy studies showed that these were less cost-effective. However, long-term use of the infusion therapies appears to improve their cost-effectiveness and in addition, several strategies are underway to reduce these high costs.

Indexed as

Parkinson DiseaseAntiparkinson AgentsApomorphineCost-Benefit AnalysisHumansLevodopaQuality of LifeAntiparkinson AgentsApomorphineLevodopacontinuous subcutaneous apomorphine infusioncost-effectivenessdeep brain stimulationlevodopa-carbidopa intestinal gelParkinson’s diseasequality adjusted life year

Identifiers

PMID33386813
PMCPMC8150660
OpenAlexW3114494207

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.