Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease
Background: Alcohol use disorder (AUD) is a major public health concern and cause of mortality and morbidity. Alcohol-associated liver disease (ALD) is a debilitating complication of AUD, mitigated by abstinence from alcohol use. Deep brain stimulation (DBS) is emerging as a potential treatment for...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | Brain Stimulation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X25000166 |
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| author | Oluwatofunmi A. Abiola Collin M. Lehmann Khaled Moussawi Hawre Jalal |
| author_facet | Oluwatofunmi A. Abiola Collin M. Lehmann Khaled Moussawi Hawre Jalal |
| author_sort | Oluwatofunmi A. Abiola |
| collection | DOAJ |
| description | Background: Alcohol use disorder (AUD) is a major public health concern and cause of mortality and morbidity. Alcohol-associated liver disease (ALD) is a debilitating complication of AUD, mitigated by abstinence from alcohol use. Deep brain stimulation (DBS) is emerging as a potential treatment for AUD. However, its cost-effectiveness compared to the standard medical treatment is unclear. Objective: To estimate the cost-effectiveness of DBS compared to medical management for patients with AUD and ALD. Methods: We utilized a decision analytic model based on published literature to conduct a cost-effectiveness analysis of costs and health outcomes for DBS and medical management in patients with AUD and ALD. We also carried out a threshold analysis to determine the probability of success necessary for DBS to be cost-effective. Costs were measured in 2024 US dollars and effectiveness in quality-adjusted life years (QALYs). We used a time horizon of 1–2 years and adopted a societal perspective. Results: Our results show that for AUD patients in general, DBS is not cost-effective at any DBS success rate. However, for advanced ALD patients, defined as fibrosis stage 3 or beyond DBS becomes cost-effective. For these patients, DBS is cost-effective over a two-year period at a $100,000 willingness-to-pay threshold at DBS success rates greater than 53 %. For advanced decompensated ALD patients, DBS is cost-effective over a one-year period at DBS success rate greater than 35 %. Conclusion: Should it prove efficacious, DBS may be cost-effective for patients with AUD and ALD. Thus, future randomized controlled trials to evaluate its efficacy are warranted. |
| format | Article |
| id | doaj-art-c416efe20b8f4d3795410766150f838a |
| institution | Kabale University |
| issn | 1935-861X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Stimulation |
| spelling | doaj-art-c416efe20b8f4d3795410766150f838a2025-02-05T04:31:38ZengElsevierBrain Stimulation1935-861X2025-03-01182122131Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver diseaseOluwatofunmi A. Abiola0Collin M. Lehmann1Khaled Moussawi2Hawre Jalal3Department of Psychiatry, School of Medicine, University of Pittsburgh, USADepartment of Psychiatry, School of Medicine, University of Pittsburgh, USADepartment of Psychiatry, School of Medicine, University of Pittsburgh, USA; Department of Neurology, School of Medicine, University of California San Francisco, USA; Corresponding author. Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA.School of Epidemiology and Public Health, University of Ottawa, Canada; Corresponding author.Background: Alcohol use disorder (AUD) is a major public health concern and cause of mortality and morbidity. Alcohol-associated liver disease (ALD) is a debilitating complication of AUD, mitigated by abstinence from alcohol use. Deep brain stimulation (DBS) is emerging as a potential treatment for AUD. However, its cost-effectiveness compared to the standard medical treatment is unclear. Objective: To estimate the cost-effectiveness of DBS compared to medical management for patients with AUD and ALD. Methods: We utilized a decision analytic model based on published literature to conduct a cost-effectiveness analysis of costs and health outcomes for DBS and medical management in patients with AUD and ALD. We also carried out a threshold analysis to determine the probability of success necessary for DBS to be cost-effective. Costs were measured in 2024 US dollars and effectiveness in quality-adjusted life years (QALYs). We used a time horizon of 1–2 years and adopted a societal perspective. Results: Our results show that for AUD patients in general, DBS is not cost-effective at any DBS success rate. However, for advanced ALD patients, defined as fibrosis stage 3 or beyond DBS becomes cost-effective. For these patients, DBS is cost-effective over a two-year period at a $100,000 willingness-to-pay threshold at DBS success rates greater than 53 %. For advanced decompensated ALD patients, DBS is cost-effective over a one-year period at DBS success rate greater than 35 %. Conclusion: Should it prove efficacious, DBS may be cost-effective for patients with AUD and ALD. Thus, future randomized controlled trials to evaluate its efficacy are warranted.http://www.sciencedirect.com/science/article/pii/S1935861X25000166Cost-effectivenessDeep brain stimulationAlcohol use disorderAlcoholic liver disease |
| spellingShingle | Oluwatofunmi A. Abiola Collin M. Lehmann Khaled Moussawi Hawre Jalal Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease Brain Stimulation Cost-effectiveness Deep brain stimulation Alcohol use disorder Alcoholic liver disease |
| title | Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| title_full | Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| title_fullStr | Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| title_full_unstemmed | Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| title_short | Cost-effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| title_sort | cost effectiveness analysis of deep brain stimulation for the treatment of alcohol use disorder and alcoholic liver disease |
| topic | Cost-effectiveness Deep brain stimulation Alcohol use disorder Alcoholic liver disease |
| url | http://www.sciencedirect.com/science/article/pii/S1935861X25000166 |
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