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Deep Brain Stimulation Cost, Insurance, and International Prices

Deep Brain Stimulation Cost, Insurance, and International Prices

Deep Brain Stimulation cost is around $130.000 on average when paid out of pocket. Deep Brain Stimulation is an advanced treatment, requiring a multidisciplinary team, specialized equipment, and maintenance. Here are the key points from our article explaining the costs:

  • The cost of Deep Brain Stimulation will add up over the years, up to $525.000, as it’s a continuous treatment.

  • This cost includes various parts such as pre-surgery expenses, the device itself, surgical fees, post-surgery costs, and possibly additional expenses later on.

  • While insurance coverage for DBS is widely available for conditions like Parkinson’s, essential tremor, and dystonia, it may not be covered for OCD and epilepsy by all insurance
    providers.

  • Despite the ongoing expense, DBS offers long-term benefits such as reducing medication
    costs, allowing patients to return to work, and enabling financial independence.

  • DBS is considered a cost-effective and advantageous treatment compared to medication-based approaches or other treatment options for Parkinson’s and OCD, significantly enhancing patients’ quality of life.

  • The cost of DBS can vary from country to country due to differences in healthcare systems and regulations, although patients can potentially lower expenses by seeking treatment abroad.
Deep Brain Stimulation Cost Breakdown Chart

How much does Deep Brain Stimulation cost?

The cost of deep brain stimulation is shown in the table below: 

 Average Cost Average Cost in 10+ yrs
The US$130.000$525.000
The UK$65.000$115.000
Europe$64.000$175.000
Asia$40.000$120.000
Turkey$35.000$90.000

We have gathered the price data from 10 different resources, including data and studies published by researchers at the University of Amsterdam,  Seoul National University Hospital, UK National Institute for Health Research, University of California, and Humboldt University.

Deep Brain Stimulation is a continuous treatment, and the costs to maintain the treatment add up over the years. The treatment is the most expensive in the first year, because of the surgery. After the first year, the costs mostly include the maintenance of stimulation parameters and battery replacement. 

How to break down the cost of Deep Brain Stimulation?

We can break down the costs of Deep Brain Stimulation surgery into 5 main components; pre-operation costs, device costs, in-surgery costs, post-operation costs, and additional costs after the surgery.

  • The pre-operation costs include every consult, imaging, blood work, and other tests that determine if you’re fit for surgery.

  • Device cost includes the costs of all device components. 

  • In-surgery costs include everything surgery-related, such as the surgeon’s fee, cost of the operation room, anesthesia, hospital stay, imaging, and localization tools used during the surgery.

  • Post-operation costs include battery replacement and programming visits. 

  • Additional post-operation costs can include services such as physical therapy, speech therapy, dietician, and psychiatric consult if needed. 

Pre-op costs

  • Physical exam: $150-$500

A routine physical exam involves checking your vitals, such as blood pressure, heart rate, and lung functions, and a visual exam of the body.

  • Neuropsycological evaluation: $1000-$5000

Neuropsychological evaluation is performed to test the cognitive abilities of the patient. If the patient’s cognitive abilities are in decline or have memory issues, it can be a contraindication for the surgery. This evaluation also tests if the patient has an active psychological condition such as depression or anxiety. These psychological conditions need to be treated before surgery. 

  • Neurosurgical evaluation: $200-$500

A neurosurgical evaluation allows the surgeon to determine if you’re a good candidate for the surgery. The surgeon will look at your brain’s condition and the extent of the illness. Depending on your condition, they will decide if you can get the surgery or not. This will also help the neurosurgeon decide if the surgery should be performed asleep or awake. The patient will go through at least 2 sessions of neurosurgery consults.

  • Brain MRI: $1000-$8000
  • Brain CT: $500-$4000

Brain imaging is crucial for DBS. Imaging before surgery will allow your care team to determine the extent of your condition, and consider potential lead placement locations. 

  • Complete Blood Count: (CBC) $50-$300
  • Electrolytes Panel: $40-$200
  • Blood Type Panel: $30-$200 for ABO testing, $30-$150 for RH testing
  • Coagulation Panel: $50-$250
  • Hepatic Functional Panel: $30-$150
  • THS panel: $50-$250

A comprehensive blood work is performed to determine if the patient is fit for surgery. Most of these tests are routinely performed before almost all surgeries. These tests give overall information about your health, your blood’s ability to clot, and liver functions. 

  • Urinalysis: $20-$100
  • Urine Toxicology Screen: $100-$800

Urinalysis is performed routinely to decide if the patient is fit for surgery. A toxicology report is run to analyze the prescription and non-prescription drugs in the patient’s system. Being in active addiction is a contraindication for DBS surgery.

  • Pregnancy test: $20-$180

A urine or serum pregnancy test is required if the patient is a female in her fertile years.

  • EKG/ECG: $40-$400
  • Chest x-ray: $100-$700

An EKG/ECG and a chest x-ray are required for patients over 45 to determine if their cardiovascular health is well enough for surgery.

DBS Device

Deep Brain Stimulation device components include the leads, the extension wires, the neurostimulator, the patient controller, all together the price is around $15.000-$30.000

Non-rechargeable DBS batteries cost less compared to rechargeable ones. Non-rechargeable batteries need to be replaced every 3-5 years. Rechargeable DBS batteries are initially more expensive. However, they have a lifespan of 10-15 years before a replacement is needed. 

DBS devices are expensive because they are made using a time-consuming and costly process where electrodes are assembled by hand, according to a paper by Prof. Joachim K Krauss of Hannover Medical School, and colleagues. 

In-surgery costs

  • Surgeon’s and staff fees: Highly Variable

In the operating room, in addition to the neurosurgeon and their assistant, there will also be an anesthesiologist and their assistant. The payment for the surgical staff will be determined by their contract with the hospital. 

  • Operating Room: $20.000-$40.000 for 5 hours of theatre time

Operating room costs are charged by the minute. Deep Brain Stimulation surgery can take anywhere between 3 to 5 hours. 

  • Anesthesia fee: $3000-$5000

Deep Brain Stimulation surgery can be performed asleep with general anesthesia, or awake under light sedation and local anesthesia.

  • Hospital stay: $3000-$10.000 a day

After surgery, patients will stay in the hospital for 1-4 days. Depending on their condition, they’ll be in the ICU after surgery. ICU stays are significantly more expensive. 

  • In-surgery imaging: $500-$4000

A CT scan is used during surgery to confirm the location of the lead placement.

  • Localization equipment: $1000-$2500

Localization equipment includes the costs to use the stereotactic headframe, and the computer software to determine the location for lead implantation. 

Post-op costs

  • Battery Replacement: $7.000-$25.000

After the operation, depending on the kind of battery you have, you need to get it replaced every 3-5 years for non-rechargeable models and 10-15 years for rechargeable models.

  • DBS programming: $150-$200

After the operation, you’ll need to make a few visits to your neurologist to adjust stimulation parameters. In the first year, these appointments can be every 3 months. After the first year, the appointments will take place every six months or once a year. You’ll need to get your device reprogrammed with every battery change. In the first year, patients will go through at least 6 sessions of programming.

Additional Post-op costs

  • Physical & occupational therapy: 100$-300$

Deep Brain Stimulation is not effective for Parkinson’s symptoms such as balance problems, freezing of gait, and other non-motor symptoms. After DBS, some patients can benefit from physical & occupational therapy to improve these symptoms.

  • Speech therapy: $100-$400

Despite undergoing DBS, speech impediments associated with Parkinson’s, such as Dysarthria, Dysphonia, and Hypophonia, may persist. These conditions can also be worsened as a side effect of stimulation. While in some instances, adjusting stimulation parameters may manage speech difficulties caused by stimulation, it is not always effective. When it comes to the choice between speech problems and reducing tremors, many patients choose reducing tremors and enduring speech difficulties. In these cases, or as the disease progresses, speech therapy becomes essential.

  • Dietician: $100-$200

After Deep Brain Stimulation, patients will gain about 9.3 to 9.7 kilograms according to research from the Center for Parkinson’s Disease and Movement Disorders in Italy. This is because patients no longer burn an excessive amount of calories due to involuntary movements. Most patients will benefit from receiving nutritional support from a registered dietitian after DBS, especially those who have comorbidities such as diabetes. 

  • Psychiatry: $100-$300

After DBS, psychiatric side effects can present such as anxiety, apathy, depression, hypomania, or Impulse Control Disorder. If these side effects arise, they need to be treated by a psychiatrist. 

Does insurance cover Deep Brain Stimulation?

Yes and no, it depends on the type of insurance you have and your condition. Insurances that do and don’t cover DBS are as follows:

 Parkinson’sEssential TremorDystoniaOCDEpilepsy
MedicareYesYesYesYesYes
MedicaidYesYesYesYesYes
Veteran’s AffairsYesN/AN/AN/AN/A
Private Health InsuranceYesYesYesNoNo
NHSYesYesYesNoYes

In the United States, Medicare and Medicaid can cover Deep Brain Stimulation for Parkinson’s, essential tremor, dystonia, OCD, and epilepsy if it’s deemed medically necessary, individualized to the person with no contraindications for the treatment.

Veteran’s Affairs can cover Deep Brain Stimulation for Parkinson’s disease.

Most private health insurance companies can cover Deep Brain Stimulation for the treatment of Parkinson’s disease, essential tremor, and dystonia. Most private insurance companies don’t cover DBS for OCD, or epilepsy. Contact your service provider to receive your policy and to learn if pre-authorization is required.

In the United Kingdom, NHS covers Deep Brain Stimulation for the treatment of Parkinson’s, essential tremor, dystonia, and epilepsy. The NHS does not cover DBS for OCD as NICE guidelines deem the treatment experimental. 

What are the financial implications of Deep Brain Stimulation in the long term?

The long-term financial implications of Deep Brain Stimulation mainly include recurring costs to maintain the treatment, and the cost of lifestyle changes afterward:

  • After the first year, patients will visit the neurologist every 6 months to a year to adjust stimulation parameters if needed. 

  • Depending on the device, battery replacement is needed every 3-5 years for non-rechargeable devices, and every 10-20 years for rechargeable ones. The battery replacement cost includes the new battery’s price and the procedure to place it.

  • Depending on the diagnosis of the patient and the lead placement, medications and the amount spent on medications can be significantly reduced. 

  • When stimulation starts to treat symptoms adequately, patients can gain independence, take a more active part in their personal care, and reduce associated costs. Patients can even go back to work and gain back their financial independence. 

  • As Deep Brain Stimulation does not stop the progression of the disease; medication, lifestyle, and healthcare costs can still come up in the future.

How does Deep Brain Stimulation cost compare to other treatments?

Compared to other treatment options, such as pharmaceutical treatment, Deep Brain Stimulation is a cost-effective treatment for movement disorders and OCD. 

In multiple cost-effectiveness analyses focusing on different illnesses, it’s found that Deep Brain Stimulation significantly improves the quality of life parameters, and even helps patients live longer lives. In comparison, standard treatment with medication can get just as expensive as Deep Brain Stimulation, but won’t have significant benefits to the patient

Compared to Deep Brain Stimulation, Ablation Surgery is a more affordable option. Ablation surgery does not require multiple appointments to fine-tune stimulation parameters, or battery replacement every few years. However, unlike Deep Brain Stimulation, Ablation Surgery is permanent, non-reversible, and highly invasive

How much does Deep Brain Stimulation cost around the world?

The cost of Deep Brain Stimulation around the world is comparable across the UK ($65.000), Europe ($64.000), and Asia ($40.000). However, the United States stands out as being one of the most expensive countries where it costs $130.000 to get DBS surgery. 

Deep Brain Stimulation Cost Around The World

65.5% of Americans are insured through private companies, according to Health Insurance Coverage in the United States: 2022 published by the United States Census Bureau. Private health insurance in the US is notorious for exorbitant pricing and makes one jump through several hoops before providing any coverage. Private insurance companies and private hospitals also have the incentive to make a profit, which can lead them to raise their prices more than what is necessary.

In contrast, most developed countries in Europe and Asia, like the UK or Turkey offer subsidized national healthcare or universal healthcare to their citizens, where private insurance is an additional option. This way, healthcare services can be extremely affordable, or even free for all citizens. National healthcare is also more likely to cover DBS treatment for OCD and epilepsy when most private insurance companies refuse coverage for the treatment of these diseases.

Can you get Deep Brain Stimulation in another country to reduce the cost?

Yes, you can reduce the cost of Deep Brain Stimulation surgery by getting the treatment in another country. Traveling to another country can be the best option if you can’t afford the treatment in your home country, or can’t receive the treatment at all due to a lack of coverage for your disease. 

Medical tourism involves traveling to another country to receive medical treatment at a lower cost or for other reasons such as access to specialized procedures or shorter wait times. Most patients choose to get Deep Brain Stimulation in Turkey, or other similar countries where high-quality healthcare services are affordable. 

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