Skip to main content

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.

Publication ,  Journal Article
Patel, NP; Wu, C; Lad, SP; Jameson, J; Kosek, P; Sayed, D; Waldorff, EI; Shum, LC; Province-Azalde, R; Kapural, L
Published in: J Neurosurg Spine
February 1, 2023

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 (EQ-5D-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 postcrossover 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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

February 1, 2023

Volume

38

Issue

2

Start / End Page

249 / 257

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Stimulation
  • Spinal Cord
  • Quality of Life
  • Orthopedics
  • Humans
  • Failed Back Surgery Syndrome
  • Cost-Benefit Analysis
  • Chronic Pain
  • Back Pain
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Patel, N. P., Wu, C., Lad, S. P., Jameson, J., Kosek, P., Sayed, D., … Kapural, L. (2023). 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. J Neurosurg Spine, 38(2), 249–257. https://doi.org/10.3171/2022.9.SPINE22416
Patel, Naresh P., Chengyuan Wu, Shivanand P. Lad, Jessica Jameson, Peter Kosek, Dawood Sayed, Erik I. Waldorff, Laura C. Shum, Rose Province-Azalde, and Leonardo Kapural. “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.J Neurosurg Spine 38, no. 2 (February 1, 2023): 249–57. https://doi.org/10.3171/2022.9.SPINE22416.
Patel NP, Wu C, Lad SP, Jameson J, Kosek P, Sayed D, Waldorff EI, Shum LC, Province-Azalde R, Kapural L. 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. J Neurosurg Spine. 2023 Feb 1;38(2):249–257.

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

February 1, 2023

Volume

38

Issue

2

Start / End Page

249 / 257

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Stimulation
  • Spinal Cord
  • Quality of Life
  • Orthopedics
  • Humans
  • Failed Back Surgery Syndrome
  • Cost-Benefit Analysis
  • Chronic Pain
  • Back Pain