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- Title
Cost-effectiveness of 10-kHz spinal cord stimulation therapy compared with conventional medical management over the first 12 months of therapy for patients with nonsurgical back pain: randomized controlled trial.
- Authors
Patel, Naresh P.; Chengyuan Wu; Lad, Shivanand P.; Jameson, Jessica; Kosek, Peter; Sayed, Dawood; Waldorff, Erik I.; Shum, Laura C.; Province-Azalde, Rose; Kapural, Leonardo
- Abstract
OBJECTIVE This analysis evaluated if spinal cord stimulation (SCS) at 10 kHz plus conventional medical management (CMM) is cost-effective compared with CMM alone for the treatment of nonsurgical refractory back pain (NSRBP). METHODS NSRBP subjects were randomized 1:1 into the 10-kHz SCS (n = 83) or CMM (n = 76) group. Outcomes assessed at 6 months included EQ-5D 5-level (EQ-5D-5L), medication usage, and healthcare utilization (HCU). There was an optional crossover at 6 months and follow-up to 12 months. The incremental cost-effectiveness ratio (ICER) was calculated with cost including all HCU and medications except for the initial device and implant procedure, and cost effectiveness was analyzed based on a willingness-to-pay threshold of < $50,000 per quality-adjusted life-year. RESULTS Treatment with 10-kHz SCS resulted in a significant improvement in quality of life (QOL) over CMM (EQ5D-5L index score change of 0.201 vs −0.042, p < 0.001) at a lower cost, based on reduced frequency of HCU resulting in an ICER of −$4964 at 12 months. The ICER was −$8620 comparing the 6 months on CMM with post cross over on 10-kHz SCS. CONCLUSIONS Treatment with 10-kHz SCS provides higher QOL at a lower average cost per patient compared with CMM. Assuming an average reimbursement for device and procedure, 10-kHz SCS therapy is predicted to be cost effective for the treatment of NSRBP compared with CMM within 2.1 years.
- Publication
Journal of Neurosurgery: Spine, 2023, Vol 38, Issue 2, p249
- ISSN
1547-5654
- Publication type
Article
- DOI
10.3171/2022.9.SPINE22416