High-frequency 10 kHz Spinal Cord Stimulation for Chronic Back and Leg Pain: Cost-consequence and Cost-effectiveness Analyses. Issue 11 (November 2020)

• Record Type: Journal Article
• Authors: Taylor, Rod S.; Bentley, Anthony; Campbell, Bruce; Murphy, Kieran
• Is Part Of: Clinical journal of pain. Volume 36:Issue 11(2020)
• Publication Date: 2020-11
• Subjects: spinal cord stimulation -- economic evaluation -- back and leg pain -- cost-utility; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesia -- Periodicals; 616.047205
• DOI: 10.1097/AJP.0000000000000866
• Languages: English
• ISSNs: 0749-8047

Abstract

Abstract : Objectives: There is good evidence that spinal cord stimulation (SCS) is effective for reducing chronic back and leg pain (CBLP). SENZA randomized controlled trial showed high-frequency (10 kHz) stimulation (10 kHz-SCS) is clinically superior to traditional low-frequency SCS (LF-SCS). Undertake cost-consequence and cost-effectiveness analysis of 10 kHz-SCS compared with LF-SCS. Methods: A probabilistic decision tree and Markov decision analytic model was used to synthesize data on CBLP outcomes and costs over a 15-year time horizon from a UK National Health Service perspective using data from the SENZA randomized controlled trial and other publications. Results are expressed as incremental cost per quality-adjusted life year (QALY) in 2016 Pounds Sterling. Results: 10 kHz-SCS is cost-saving and cost-effective compared with LF-SCS, with mean cost-savings of £7170 (95% confidence interval: £6767-£7573) and £3552 (95% confidence interval: £3313-£3792) per patient compared with nonrechargeable and rechargeable LF-SCS devices, respectively. 10 kHz-SCS has a 95% likelihood of being cost-effective at a willingness-to-pay threshold of £20, 000 per QALY. Our findings were robust across a wide range of sensitivity analyses. Conclusions: There is a strong economic case for choosing 10 kHz-SCS over LF-SCS for CBLP. Furthermore, 10 kHz-SCS has clinical advantages not captured in our analysis, including shorter, and more predictable procedure times. Abstract : Supplemental Digital Content is available in the text.