Long-Term Deep Brain Stimulation for Parkinson's Disease is Associated with Progressive Reduction in Medication Utilization and Cost

Patients with Parkinson’s Disease (PD) treated with Deep Brain Stimulation (DBS) typically reduce anti-PD medication use by 25-50% within 6 months of device placement, but whether the reduction is maintained long-term is less clear. We performed a medical record review of 18 patients with PD treated with DBS and 18 matched control patients treated with medications alone and compared their patterns of medication use. Dose and frequency were extracted from each progress note and converted to levodopa equivalent daily dose and cost. Participants were 20 men and 16 women, with an average age of 63.5 years and 12.9 years since the initial diagnosis of PD. Before initiation of DBS therapy, average daily medication dose increased by 61 levodopa equivalents per year; after implantation, daily dose decreased by 170 levodopa equivalents per year (p=0.0172). Annual cost associated with medical management of PD averaged $6661 ± 3894, which decreased by $2.93/day after implantation (p=0.0199). Our results demonstrate that reductions in anti-PD medication use continue for at least three years after DBS initiation, and generate significant cost savings.