Category: Parkinson’s Disease: Clinical Trials
Objective: We evaluated the cost effectiveness of two speech and language therapy techniques compared with no therapy in people with Parkinson’s disease who have problems in communication.
Background: Speech impairment in PD can impact on social activities and participation, leading to social withdrawal and reduced quality of life.
Method: An incremental cost-utility analysis alongside the PD COMM trial was conducted from a UK National Health Service (NHS) perspective comparing LSVT with standard NHS speech and language therapy (SLT) and no speech therapy (control). Patient level data was collected on number of SLT sessions and PD-related resource use and SLT sessions were costed individually based on session duration and location. Health outcomes were expressed as quality adjusted life years (QALYs) using data from EQ-5D-5L. Additional analyses were carried out to explore the impact of using capability outcomes, alternative perspectives, and different delivery modes for LSVT.
Results: LSVT was associated with a slight improvement in QALYs compared to both NHS SLT and no therapy at a higher cost. The base case analysis revealed that the Incremental Cost Effectiveness Ratio (ICER) of LSVT versus no therapy was £197,772/QALY gained (Incremental cost: £1582.18 (95% CI, £1325.21 to £1892.23); Incremental QALYs (0.008 (95% CI, -0.020 to 0.040)) and £77,017/QALY gained when comparing LSVT to NHS SLT ((Incremental cost: £652.76 (95% CI, £381.69 to £934.26; incremental QALYs 0.012 (95% CI, -0.017 to 0.042)). Compared with no SLT, NHS SLT was dominated as it was more costly and less effective. Sensitivity analysis showed that the most cost-effective method was a combination of supervised and unsupervised sessions using Companion Software, resulting in an ICER of £27,808/QALY.
Conclusion: Over a 12 month period, LSVT was not cost-effective. However, changing the mode of LSVT delivery to include half the 16 sessions with home treatment reduced LSVT costs to approach cost-effectiveness at a threshold of £30,000/QALY.
To cite this abstract in AMA style:
C. Clarke, Z. Abdali, S. Jowett, C. Rick, M. Brady, R. Woolley, C. Burton, S. Patel, P. Masterson-Algar, A. Nicoll, C. Smith, N. Ives, G. Beaton, S. Dickson, R. Ottridge, H. Nankervis, C. Sackley. Cost-effectiveness of Lee Silverman Voice Treatment LOUD (LSVT®) versus NHS Speech and Language Therapy versus control for dysarthria in Parkinson’s disease: An economic evaluation alongside the PD COMM trial [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/cost-effectiveness-of-lee-silverman-voice-treatment-loud-lsvt-versus-nhs-speech-and-language-therapy-versus-control-for-dysarthria-in-parkinsons-disease-an-economic-evaluation-alongs/. Accessed May 13, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cost-effectiveness-of-lee-silverman-voice-treatment-loud-lsvt-versus-nhs-speech-and-language-therapy-versus-control-for-dysarthria-in-parkinsons-disease-an-economic-evaluation-alongs/