Medtronic, Inc.: New Study Finds Spinal Cord Stimulation Pays For Itself In 2.5 Years

Beyond the documented relief provided to victims of chronic pain, a new study of spinal cord stimulation (SCS) suggests these therapies also offer economic benefits by paying for themselves in less than 2.5 years, according to a report in the current issue of the Journal of Pain and Symptom Management.

The initial cost of the therapy, which uses an implantable stimulator to block pain signals moving up the spinal cord, does not represent the therapy's overall costs and benefits, say five collaborating researchers from U.S. and European medical centers. Health policy decisions that restrict patient access to SCS on the basis of device and implantation costs should be reconsidered on the basis of data comparing its cost over one to three years with other pain therapies, according to the article, "The Cost Effectiveness of Spinal Cord Stimulation in the Treatment of Pain."

Chronic pain - defined as pain that persists or recurs for more than six months - can be caused by a variety of injuries and diseases, including nerve damage and cancer. In the United States alone, approximately 25 percent(1) of the population is afflicted, costing $70 billion a year in medical costs(2) and 515 million lost workdays.(3) The most common chronic pain problems involve the lower back and legs.

Implantable neurostimulation systems from Medtronic, Inc. (NYSE:MDT), have been used to treat chronic pain syndrome in more than 120,000 patients since the systems' commercial introduction in 1981.

Led by Rod Taylor, Ph.D., of the Department of Public Health and Epidemiology at the University of Birmingham, United Kingdom, the researchers reviewed and evaluated cost data from 14 carefully selected studies at medical centers around the world. These studies described cases of patients treated with SCS for failed back surgery and complex regional pain syndrome.

"Across a range of medical indications, we found that the initial healthcare acquisition costs of SCS implantation are consistently offset by a reduction in post-implant healthcare resource demand and costs," says the report.

The researchers found large variations in costs associated with the initial implant of a neurostimulation device (patient screening, device costs, physician/surgeon fees, and hospitalization) and for the post-implantation period (drugs, follow-up visits, implant revision and physical therapy). Initial implant costs ranged from $8,796 to $19,500. However, the researchers said that, "although for two years post implant the cumulative costs of SCS were in excess of those associated with non-SCS patients, the pattern reversed after about 2.5 years as patients without SCS underwent more physician visits, specialist consultations, re-hospitalization, ongoing therapy and diagnostic tests."

In one study they reviewed, initial SCS costs per patient were $16,936 (Canadian), but their maintenance cost dropped to $1,094 a year (Canadian) compared with $7,291 (Canadian) for patients who were not treated with SCS. Overall, this study estimated that lifetime cost savings of $60,000 (U.S.) for patients receiving SCS and physical therapy over patients receiving only physical therapy.

Using standard cost-effectiveness metrics in pain management (cost per pain-free day and cost per quality-adjusted life year), the study found that "cost payback" periods as short as 15 months have been recorded, depending on relative effectiveness of SCS, generator battery life, and the level of SCS usage by patients.

"The result of this review raise important issues for health care policymakers, at a national or local level, who need to consider medium- to long-term costs, as opposed to initial, or startup, costs alone," the researchers said.