Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

Carlo Efisio Marras, Gabriella Colicchio, Luca De Palma, Alessandro De Benedictis, Giancarlo Di Gennaro, Marilou Cavaliere, Elisabetta Cesaroni, Alessandro Consales, Sofia Asioli, Massimo Caulo, Flavio Villani and Nelia Zamponi
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Carlo Efisio Marras: Neurosurgery Unit, Department of Neuroscience, IRCCS Bambino Gesù Children Hospital, 00165 Rome, Italy
Gabriella Colicchio: Department of Neurosurgery, UCSC Gemelli University Hospital, 00167 Rome, Italy
Luca De Palma: Pediatric Neurology Unit, Department of Neuroscience, IRCCS Bambino Gesù Children Hospital, 00165 Rome, Italy
Alessandro De Benedictis: Neurosurgery Unit, Department of Neuroscience, IRCCS Bambino Gesù Children Hospital, 00165 Rome, Italy
Giancarlo Di Gennaro: Neurology Unit, IRCCS Neuromed Institute, 86077 Pozzilli, Italy
Marilou Cavaliere: Neurosurgery Unit, Department of Neuroscience, IRCCS Bambino Gesù Children Hospital, 00165 Rome, Italy
Elisabetta Cesaroni: Pediatric Neurology Unit, Salesi Children Hospital, 60123 Ancona, Italy
Alessandro Consales: Pediatric Neurosurgery Unit, G. Gaslini Hospital, 16147 Genoa, Italy
Sofia Asioli: Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, Bellaria Hospital, University of Bologna, 40139 Bologna, Italy
Massimo Caulo: Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti, 66100 Chieti, Italy
Flavio Villani: Division of Clinical Neurophysiology and Epilepsy Center, IRCCS, San Martino Hospital, 16132 Genoa, Italy
Nelia Zamponi: Pediatric Neurology Unit, Salesi Children Hospital, 60123 Ancona, Italy

IJERPH, 2020, vol. 17, issue 17, 1-17

Abstract: Background : Vagus nerve stimulation (VNS) is a palliative treatment for medical intractable epileptic syndromes not eligible for resective surgery. Health technology assessment (HTA) represents a modern approach to the analysis of technologies used for healthcare. The purpose of this study is to assess the clinical, organizational, financial, and economic impact of VNS therapy in drug-resistant epilepsies and to establish the congruity between costs incurred and health service reimbursement. Methods : The present study used an HTA approach. It is based on an extensive detailed bibliographic search on databases (Medline, Pubmed, Embase and Cochrane, sites of scientific societies and institutional sites). The HTA study includes the following issues: (a) social impact and costs of the disease; (b) VNS eligibility and clinical results; (c) quality of life (QoL) after VNS therapy; (d) economic impact and productivity regained after VNS; and (e) costs of VNS. Results: Literature data indicate VNS as an effective treatment with a potential positive impact on social aspects and on quality of life. The diagnosis-related group (DRG) financing, both on national and regional levels, does not cover the cost of the medical device. There was an evident insufficient coverage of the DRG compared to the full cost of implanting the device. Conclusions : VNS is a palliative treatment for reducing seizure frequency and intensity. Despite its economic cost, VNS should improve patients’ quality of life and reduce care needs.

Keywords: vagus nerve stimulation; health technology assessment; drug-resistant epilepsy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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