lifespan is only threatened after the development of refractory disease, most typically in the late elderly, and both the costs and risks of treatment may be significant. Yet for a minority of younger patients with early refractory disease, cell-based dopaminergic replacement may be their only current hope of a productive life and lifespan. At this early stage in the development of stem cell therapeutics, little cost-benefit and risk-benefit analysis has been done to define those disease targets most appropriate for clinical development. One recent cost-benefit analysis by Barker and colleagues (Buttery and Barker, 2014), which compared the attractiveness of cell therapy in Parkinson’s disease to that of alternative standards of care, has provided both a strong precedent and roadmap by which to address this issue of comparative efficacy, which will no doubt become a critically important – and potentially contentious – issue as stem cell medicine progresses. As with several other emerging fields of medicine, stem cell neurology is a field that while still in its infancy, will demand sufficient societal resources as to suggest both the need and benefit of early prioritization of effort.
