Presented at the 2012 AAPM Annual Meeting « Back

Cost-Effectiveness of Spinal Cord Stimulation (SCS) for the Treatment of Chronic Neuropathic Pain

Lilly Chen, MS, lilly.chen@bsci.com1, Kerry Bradley, MS1, Lee T. Snook, MD2, Nitzan Mekel-Bobrov, PhD1, Bryan R. Boroski, BA3, Sally Kimbrell, MS2, Anthony S. Pineda, MPH CPHQ4, (1) Boston Scientific, Valencia, California, (2) MPMC, Sacramento, California, (3) Metropolitan Pain Management Consultants, Sacramento, California, (4) N/A, Sacramento, California

Introduction: While published analyses of clinical outcomes have been steadily increasing as well, the availability of published cost-effectiveness analyses remains relatively scarce. Materials and Methods: The study included a review of clinical outcomes and the associated costs for SCS patients treated with the Boston Scientific Precision® SCS system at the MPMC clinic. Data collected included pain rating on a visual analog scale (VAS) and direct costs, before and after the SCS implant procedure, over a median duration of 14.3 and 16.8 months pre- and post-procedure, respectively. Cost-effectiveness was assessed by estimating effectiveness in terms of VAS pain reduction. The incremental cost-effectiveness ratio (ICER) represents the additional cost incurred by the payer to obtain a reduction of 1 point in the VAS score with intervention (SCS) compared to Standard Medical Care (SMC). Results: A total of 46 patients (51% female) with a mean age of 55.3±10.6 years were included. The median pain reduction in VAS from pre- to post-procedure was 3.0 points. This improvement in pain score is both clinically significant and statistically significant (P<0.0001). The median direct costs prior to SCS were $3,438/year, compared to $2,012/year post-permanent implant procedure, adjusted for the duration of follow-up. This annual cost reduction of approximately 42% is statistically significant (P = 0.0007). With a mean per-patient SCS cost of $31,530, the ICER of SCS was $11,250 compared to SMC. Conclusion: Our study suggests that SCS provides both clinically significant and cost-effective reduction in pain, when compared to SMC over the patient’s lifetime.

Funding: None