Cost-effectiveness analysis for trigeminal neuralgia: Cyberknife vs microvascular decompression

Abstract

Rosanna Tarricone1, Giovanni Aguzzi1, Francesco Musi1, Laura Fariselli2, Andrea Casasco31Economic Evaluation Area, CERGAS Centre for Research on Healthcare Management-Bocconi University, Milan, Italy; 2Radiotherapy Department, Carlo Besta National Neurological Institute, Milan, Italy; 3Centro Diagnostico Italiano, Milan, ItalyBackground/Aims: We present the preliminary results of a cost-effectiveness analysis of cyberknife radiosurgery (CKR) versus microvascular decompression (MVD) for patients with medically unresponsive trigeminal neuralgia.Methods: Direct healthcare costs from hospital’s perspective attributable to CKR and MVD were collected. Pain level caused by trigeminal neuralgia was measured through the Barrow Neurological Institute pain intensity scoring criteria, at admission and after an average of 6 months follow-up.Results: 20 patients for both arms were enrolled, for a total of 40 patients. The two procedures resulted equally effective at 6 month follow-up, with different resources consumption: CKR reducing hospital costs by an average of 34% per patient. The robustness of these results was confirmed in appropriate sensitivity analyses.Conclusion: CKR resulted to be a cost-saving alternative compared with the surgical intervention.Keywords: decision-making, cost-effectiveness analysis, Cyberknife, microvascular decompression, trigeminal neuralgia