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How long does remission last for those who benefit from TMS? If it’s not permanent, wouldn’t future additional tx need to be calculated in? If periodic ‘touch ups’ are needed, does their effectiveness for the patient change over time? or in other words, could it cost more over time? This article doesn’t provide the level of detail needed to predict real costs, which could be more persuasive to plan administrators. They are, after all, business people who depend on numbers.

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In some of the referenced papers, those numbers are addressed. The quality adjusted life year takes that into account, by definition however.

That's the point of QALY as a metric--it's benefit times durability baked into the math.

The following article is one that addresses that question in some detail.

https://www.sciencedirect.com/science/article/pii/S0165178123001300

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