Deep Brain Stimulation Treatment Cost in India – DBS Surgery in India
I have been asked several times about the Deep Brain Stimulation Treatment cost in India, especially at our center. The question is very simple but the answer to this is very complex.
It is very important to understand that we are talking about the cost. What is the difference between the cost and price?
The cost is defined as the total consideration for acquiring something, and the price is defined as purely the value of the product.
For example cost for buying the car would also include the cost of insurance associated with it, servicing and maintenance.
Where as the price is only reflecting the value of the car.
Having understood this difference let us understand the cost of DBS surgery.
What is DBS surgery?
DBS surgery is a short form for Deep Brain Stimulation surgery. The detailed description of this is available at other pages on our website, however, let me describe this in short.
Deep Brain stimulation surgery involves implantation of electrodes into the target cells of the brain.
This are connected to a pacemaker, which is like a battery and can be programed from outside.
Pacemaker delivers current to the target cells and controls the function or modulates the function of the cells.
DBS surgery has been used for several indication which includes movement disorders, psychiatric disorders pain.
There are several important aspects about DBS surgery to consider before offering this treatment.
We will use movement disorders, and amongst movement disorder Parkinson’s disease, as the main disease to described the various aspects which are important for a successful DBS surgery.
This all points also apply to all other indications of DBS surgery.
What are the Requisites for a successful DBS Surgery?
Selection of Patients
This is the most important aspect about a successful DBS program. This is where most of the centers make mistake, by either offering surgery to the wrong candidates or too early or too late in the disease.
Only selecting the right candidate is not important but also tailoring the expectation and understanding the expectation of the patient is equally important, as not all problems can be solved by DBS and if the patient is made aware about this before the surgery he will be more comfortable to accept the outcome of the DBS surgery after he has undergone the procedure.
At our centre we have an elaborate protocol to ensure that the patient understands all the aspects of surgery before he comes in for the surgical procedure.
This makes it very easy for patient to undergo this procedure and for us to manage him after the Surgery.
Another important aspect about the patient selection that many centres forget, is to evaluate the patient as a whole.
These patients are elderly patient and many of them have additional problems that may also require attention.
The common problems that require attention include Psychiatric issues, urological problems and dental problems.
We have a team of doctors who have been working with the DBS Team for last 20 years and who understand these problems properly and hence provide the most optimal treatment required to resolve these problems.
Correct selection of the patient is the most integral part of a successful outcome.
TYPES OF DBS IMPLANTS
There are several types of DBS implants available in India. Most of the implants that are available around the word available.
However, selecting the right DBS for the right kind of indication and for the right type of patient is very important.
There are rechargeable and non-rechargeable devices available; 8 contact points and four contact point leads available; all of them have different functionality and different capabilities.
Some of the DBS implants are MRI compatible some of the DBS implants are non-MRI compatible.
Some last for 4 years some of them last for 25 years. Which implant is used for which patient is very crucial. Most of the time it is a solution which is tailor made based on the Patient’s geographical location, indication, age, education background, and affordability.
Like other conditions in life, most expensive implant may not be the most suitable implant for you.
Jaslok Hospital and Research Centre has been the launch sites of all the new DBS implants around the word for the first time Asia.
We have the widest experience of using different types of implants for the largest number of indications in the Asian continent.
We were the first center in India to perform DBS surgery. We started performing DBS surgery way back in 1998.
So far we have performed more than 525 DBS procedures. This is one of the largest experience by a single surgeon and a single team in the world.
Not only that, we have published extensively all our results and complications that can help us remain right on track and enhance the safety and efficacy of the procedure. Surgical protocol that we have established extensively used at several centers across the country and internationally.
We have also trained several Neurosurgeons to perform DBS surgery independently. The most important thing about any successful program is the consistency.
We are in the process of publishing our second paper on complication results, which has shown that over a period of time, the rate of our complications has continued to reduce.
Our surgical protocol have been polished and perfected over time and now we are capable of even operating elderly patient with the same level of safety that is seen for younger patients.
We have also published these results in International Scientific Journal to share as to how this Surgery can be made safe, even for elderly patients.
Postoperative management and programming
DBS surgery is an engagement for life. Once you have DBS implants your connection with the Centre is lifelong, as periodically you would need to titrate the amount of stimulation and adjust the medications that are required to optimally control the disease.
Having an experience of more than 500 patients and follow up of over 20 years we are now very confident in managing this patient’s after the surgery.
The DBS programming capabilities extend into millions, and not each of the program can be tested for each patient, otherwise the patient and the doctor both will get tired.
Hence it is very important to understand what program will work for which patient, which symptom will be improved by stimulation, which symptom will improve by medication and which are the symptoms which may not respond to either of them.
Once we are clear on this, we can communicate this to the patient and the patient can also come to terms with his disease.
We have got several requests of re-programming of the patients who have been operated at other centres and have failed to obtain response to DBS.
They approach us with the hope that we will be able to redo surgery and give them the benefit that they had expected out of surgery.
Most of the time, with the technological knowledge, capabilities of programming and understanding of the medications we have been able to fix the problems, not as much as we would like to, so as to avoid repeat surgery.
As mentioned earlier Parkinson’s patients’ management does not only involve the treatment of Parkinson’s disease but requires management of all the other problems that come along with age and associated with Parkinson’s disease.
The most common problems that the patient have encountered after DBS, as a course of ageing process, include cardiac issues, urological problems, cataract and spinal problems.
Most of the time, the patient chooses to return back to our Centre for management of all these problems as they find the confidence in the team of doctors who have been working with us to help first effectively treat these problems of patients in the most optimal fashion and not offer surgery as a solution for each and every problem.
Even if they have to undergo surgery the Parkinson’s Team ensures that they undergo a safe surgical procedure and come out without any other complication.
NOW BEFORE ASKING FOR THE COST ONE SHOULD CONSIDER ALL THESE ASPECTS. THERE IS NO PRICE TO SAFETY, WHEN IT COMES TO LIFE.
Typical cost of DBS surgery at our centre
The following graph shows the cost of DBS surgery aross the world.
As mentioned earlier, the cost of surgery will be highly dependent on the type of implants that you use, the type of indication for which it is used and the length of the hospital stay. Typically, at our centre the hospital stay is usually for 8-10 days as against and hospital stay of 3 or 4 days at other centres.
The reason being that, in India, the cost of hospital stay is very low.
He prefer the patient to stay in the hospital and adjust his medication and titration of DBS program before he goes home so that he getd the most benefit of DBS surgery.
We do not want the patient to spend money in the Hotel! After eighth day we have the sutures removed to ensure that the wound has healed well so that the patient is safe to travel back to from wherever he has come from.
What is included in the cost of DBS surgery?
We can share these details about our Center.
- It covers 10 days of hospitalization.
- It covers all the cost related to surgery, investigations and surgeon fees.
- It covers all costs related to implants and hardware .
- It also covers all the cast of consumables and medications during the course of the stay.
- It covers the cost of programming and follow up visits for six weeks.
- It does not cover the cast off any other medical professionals engaged in the treatment of the patient, any additional day of hospitalization beyond 10 days or incidental expenses.
Does Insurance Company cover the DBS surgical cost and replacement cost of pacemaker?
This is one of the most important USP of our Centre.
At our centre more than 90% of our patients have been able to claim the benefit from the insurance companies, either towards the DBS surgery or towards the replacement of the pacemaker.
We have done a lot of background work for this and we understand the difficulties of the patient and the need for them to be reimbursed.
There is an efficient team which works for the medical reimbursement with the insurance companies and helps the patient to get the maximum possible reimbursement from the insurance companies.
All the paperwork necessary for this purpose is conducted by this team.
All communications are either done electronically or through mail and hence the patient or the relatives does not have to travel to the hospital for each and every document and signature that is required.