Implementation of intermittent theta burst stimulation compared to conventional repetitive transcranial magnetic stimulation in patients with treatment resistant depression: A cost analysis
Autoři:
Andrew B. Mendlowitz aff001; Alaa Shanbour aff004; Jonathan Downar aff004; Fidel Vila-Rodriguez aff006; Zafiris J. Daskalakis aff001; Wanrudee Isaranuwatchai aff002; Daniel M. Blumberger aff001
Působiště autorů:
Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health, Toronto, ON, Canada
aff001; Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
aff002; Toronto Health Economics and Technology Assessment Collaborative, Toronto, ON, Canada
aff003; Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
aff004; MRI-Guided rTMS Clinic and Krembil Research Institute, University Health Network, Toronto, ON, Canada
aff005; Non-Invasive Neurostimulation Therapies (NINET) Laboratory, University of British Columbia Hospital, Vancouver, BC, Canada
aff006; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
aff007; The Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
aff008
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222546
Souhrn
Background
Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based treatment for depression that is increasingly implemented in healthcare systems across the world. A new form of rTMS called intermittent theta burst stimulation (iTBS) can be delivered in 3 min and has demonstrated comparable effectiveness to the conventional 37.5 min 10Hz rTMS protocol in patients with depression.
Objectives
To compare the direct treatment costs per course and per remission for iTBS compared to 10Hz rTMS treatment in depression.
Methods
We conducted a cost analysis from a healthcare system perspective using patient-level data from a large randomized non-inferiority trial (THREE-D). Depressed adults 18 to 65 received either 10Hz rTMS or iTBS treatment. Treatment costs were calculated using direct healthcare costs associated with equipment, coils, physician assessments and technician time over the course of treatment. Cost per remission was estimated using the proportion of patients achieving remission following treatment. Deterministic sensitivity analyses and non-parametric bootstrapping was used to estimate uncertainty.
Results
From a healthcare system perspective, the average cost per patient was USD$1,108 (SD 166) for a course of iTBS and $1,844 (SD 304) for 10Hz rTMS, with an incremental net savings of $735 (95% CI 688 to 783). The average cost per remission was $3,695 (SD 552) for iTBS and $6,146 (SD 1,015) for 10Hz rTMS, with an average incremental net savings of $2,451 (95% CI 2,293 to 2,610).
Conclusions
The shorter session durations and treatment capacity increase associated with 3 min iTBS translate into significant cost-savings per patient and per remission when compared to 10Hz rTMS.
Klíčová slova:
Biology and life sciences – Engineering and technology – Research and analysis methods – Neuroscience – People and places – Population groupings – Professions – Geographical locations – Medicine and health sciences – Physiology – Health care – Health care providers – Medical doctors – Physicians – Medical personnel – Pharmacology – Pharmaceutics – Drug therapy – Drugs – Equipment – Mental health and psychiatry – Brain mapping – Electrophysiology – Neurophysiology – Bioassays and physiological analysis – Electrophysiological techniques – Brain electrophysiology – Technicians – Science policy – Science and technology workforce – Careers in research – Mood disorders – Depression – North America – United States – Transcranial stimulation – Transcranial magnetic stimulation – Antidepressants
Zdroje
1. World Health Organization. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Report by the Secretariat. Geneva, Switzerland: 2011.
2. Friedrich MJ. Depression is the leading cause of disability around the world. JAMA 2017;317(15):1517–1517.
3. Baldwin RC, Simpson S. Treatment resistant depression in the elderly: a review of its conceptualisation, management and relationship to organic brain disease. Journal of Affective Disorders 1997;46(3):163–73. doi: 10.1016/s0165-0327(97)00143-2 9547114
4. Souery D, Amsterdam J, de Montigny C, Lecrubier Y, Montgomery S, Lipp O, et al. Treatment resistant depression: methodological overview and operational criteria. European Neuropsychopharmacology 1999;9(1):83–91.
5. Rush AJ, Kraemer HC, Sackeim HA, Fava M, Trivedi MH, Frank E, et al. Report by the ACNP Task Force on Response and Remission in Major Depressive Disorder. Neuropsychopharmacology 2006;31(9):1841–53. doi: 10.1038/sj.npp.1301131 16794566
6. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report. AJP 2006;163(11):1905–17.
7. Rizvi SJ, Grima E, Tan M, Rotzinger S, Lin P, McIntyre RS, et al. Treatment-resistant depression in primary care across Canada. The Canadian Journal of Psychiatry 2014;59(7):349–57. doi: 10.1177/070674371405900702 25007419
8. Nemeroff CB. Prevalence and management of treatment-resistant depression. Journal of Clinical Psychiatry 2007;68(8):17.
9. Malhi GS, Parker GB, Crawford J, Wilhelm K, Mitchell PB. Treatment-resistant depression: resistant to definition? Acta Psychiatrica Scandinavica 2005;112(4):302–9. doi: 10.1111/j.1600-0447.2005.00602.x 16156838
10. Olchanski N, McInnis Myers M, Halseth M, Cyr PL, Bockstedt L, Goss TF, et al. The Economic Burden of Treatment-Resistant Depression. Clinical Therapeutics 2013;35(4):512–22. doi: 10.1016/j.clinthera.2012.09.001 23490291
11. Lisanby SH. Electroconvulsive Therapy for Depression. N Engl J Med 2007;357(19):1939–45. doi: 10.1056/NEJMct075234 17989386
12. Downar J, Blumberger DM, Daskalakis ZJ. Repetitive transcranial magnetic stimulation: an emerging treatment for medication-resistant depression. Canadian Medical Association Journal 2016;188(16):1175–7. doi: 10.1503/cmaj.151316 27551033
13. Getty SS, Faziola LR. Adverse effects of electroconvulsive therapy on cognitive performance. Ment Illn 2017;9(2).
14. George MS, Wassermann EM, Williams WA, Callahan A, Ketter TA, Basser P, et al. Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Neuroreport: An International Journal for the Rapid Communication of Research in Neuroscience 1995; 6(14): 1853–6.
15. Pascual-Leone A, Rubio B, Pallardó F, Catalá MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. The Lancet 1996;348(9022):233–7.
16. Brunoni AR, Chaimani A, Moffa AH, Razza LB, Gattaz WF, Daskalakis ZJ, et al. Repetitive Transcranial Magnetic Stimulation for the Acute Treatment of Major Depressive Episodes: A Systematic Review With Network Meta-analysis. JAMA Psychiatry 2017;74(2):143–52. doi: 10.1001/jamapsychiatry.2016.3644 28030740
17. Health Quality Ontario. Repetitive transcranial magnetic stimulation for treatment-resistant depression: an economic analysis. Ont Health Technol Assess Ser. 2016 March;16(6):1–51. Available from: http://www.hqontario.ca/evidence/publications-and-ohtacrecommendations/ontario-health-technology-assessment-series/econ-rtms 27110317
18. McClintock SM, Reti IM, Carpenter LL, McDonald WM, Dubin M, Taylor SF, et al. Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. The Journal of clinical psychiatry 2018;79(1).
19. O’Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biological psychiatry 2007;62(11):1208–16. doi: 10.1016/j.biopsych.2007.01.018 17573044
20. George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Archives of general psychiatry 2010;67(5):507–16. doi: 10.1001/archgenpsychiatry.2010.46 20439832
21. Blumberger DM, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, et al. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. The Lancet 2018;391(10131):1683–92.
22. Huang Y-Z, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta Burst Stimulation of the Human Motor Cortex. Neuron 2005;45(2):201–6. doi: 10.1016/j.neuron.2004.12.033 15664172
23. Di Lazzaro V, Dileone M, Pilato F, Capone F, Musumeci G, Ranieri F, et al. Modulation of motor cortex neuronal networks by rTMS: comparison of local and remote effects of six different protocols of stimulation. Journal of neurophysiology 2011;105(5):2150–6. doi: 10.1152/jn.00781.2010 21346213
24. Li CT, Chen MH, Juan CH, Huang HH, Chen LF, Hsieh JC, et al. Efficacy of prefrontal theta-burst stimulation in refractory depression: a randomized sham-controlled study. Brain 2014;137(7):2088–98.
25. Plewnia C, Pasqualetti P, Grobe S, Schlipf S, Wasserka B, Zwissler B, et al. Treatment of major depression with bilateral theta burst stimulation: a randomized controlled pilot trial. Journal of affective disorders 2014;156:219–23. doi: 10.1016/j.jad.2013.12.025 24411682
26. Brooks M. FDA Clears 3-Minute Brain Stimulation Protocol for Depression. MedScape Medical News Published Online First: 22 August 2018. Available from: https://www.medscape.com/viewarticle/901052 Cited 31 August 2018.
27. U.S. Centers for Medicare and Medicaid Services. Physician fee schedule search. 2018. Available from: https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx Cited 9 August 2018.
28. Canadian Agency for Drugs and Technology in Health. Diagnostic imaging equipment replacement and upgrade in Canada (Environmental scan; no.56). Ottawa, Ontario: 2016. Available from: https://www.cadth.ca/diagnostic-imaging-equipment-replacement-and-upgrade Cited 10 August 2018.
29. Oberman L, Edwards D, Eldaief M, Pascual-Leone A. Safety of theta burst transcranial magnetic stimulation: a systematic review of the literature. Journal of Clinical Neurophysiology 2011;28(1):67. doi: 10.1097/WNP.0b013e318205135f 21221011
30. Gaynes BN, Lloyd SW, Lux L, Gartlehner G, Hansen RA, Brode S, et al. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. J Clin Psychiatry 2014; 75(5):477–89. doi: 10.4088/JCP.13r08815 24922485
31. George MS, Taylor JJ, Short EB. The expanding evidence base for rTMS treatment of depression. Current opinion in psychiatry 2013;26(1):13. doi: 10.1097/YCO.0b013e32835ab46d 23154644
32. Glick HA, Doshi JA, Sonnad SS, Polsky D. Economic evaluation in clinical trials. OUP Oxford; 2014.
33. National Institute for Health and Care Excellence. Repetitive transcranial magnetic stimulation for depression. London, UK: 2015. Available from: https://www.nice.org.uk/guidance/ipg542/resources/repetitive-transcranial-magnetic-stimulation-for-depression-pdf-1899871923433669 Cited 13 August 2018.
34. Vallejo-Torres L, Castilla I, González N, Hunter R, Serrano-Pérez P, Perestelo-Pérez L. Cost-effectiveness of electroconvulsive therapy compared to repetitive transcranial magnetic stimulation for treatment-resistant severe depression: a decision model. Psychological medicine 2015;45(7):1459–70. doi: 10.1017/S0033291714002554 25354790
35. Milev RV, Giacobbe P, Kennedy SH, Blumberger DM, Daskalakis ZJ, Downar J, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments. Canadian journal of psychiatry 2016;61(9):561–75. doi: 10.1177/0706743716660033 27486154
36. Duprat R, Desmyter S, van Heeringen K, Van den Abbeele D, Tandt H, Bakic J, et al. Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: a fast road to remission? Journal of affective disorders 2016;200:6–14. doi: 10.1016/j.jad.2016.04.015 27107779
37. Bakker N, Shahab S, Giacobbe P, Blumberger DM, Daskalakis ZJ, Kennedy SH, Downar J. rTMS of the dorsomedial prefrontal cortex for major depression: safety, tolerability, effectiveness, and outcome predictors for 10 Hz versus intermittent theta-burst stimulation. Brain stimulation 2015;8(2):208–15. doi: 10.1016/j.brs.2014.11.002 25465290
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