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Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis

Screening trials of spinal cord stimulation (SCS) prior to full implantation of a device are recommended by expert guidelines and international regulators. The current study sought to estimate the budget impact of a screening trial of SCS and the costs or savings of discontinuing the use of a screen...

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Autores principales: Duarte, Rui V., Houten, Rachel, Nevitt, Sarah, Brookes, Morag, Bell, Jill, Earle, Jenny, Gulve, Ashish, Thomson, Simon, Baranidharan, Ganesan, North, Richard B., Taylor, Rod S., Eldabe, Sam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486155/
https://www.ncbi.nlm.nih.gov/pubmed/36147037
http://dx.doi.org/10.3389/fpain.2022.974904
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author Duarte, Rui V.
Houten, Rachel
Nevitt, Sarah
Brookes, Morag
Bell, Jill
Earle, Jenny
Gulve, Ashish
Thomson, Simon
Baranidharan, Ganesan
North, Richard B.
Taylor, Rod S.
Eldabe, Sam
author_facet Duarte, Rui V.
Houten, Rachel
Nevitt, Sarah
Brookes, Morag
Bell, Jill
Earle, Jenny
Gulve, Ashish
Thomson, Simon
Baranidharan, Ganesan
North, Richard B.
Taylor, Rod S.
Eldabe, Sam
author_sort Duarte, Rui V.
collection PubMed
description Screening trials of spinal cord stimulation (SCS) prior to full implantation of a device are recommended by expert guidelines and international regulators. The current study sought to estimate the budget impact of a screening trial of SCS and the costs or savings of discontinuing the use of a screening trial. A budget impact analysis was performed considering a study population that reflects the size and characteristics of a patient population with neuropathic pain in England eligible for SCS. The perspective adopted was that of the NHS with a 5-year time horizon. The base case analysis indicate that a no screening trial strategy would result in cost-savings to the NHS England of £400,000–£500,000 per year. Sensitivity analyses were conducted to evaluate different scenarios. If ≥5% of the eligible neuropathic pain population received a SCS device, cost-savings would be >£2.5 million/year. In contrast, at the lowest assumed cost of a screening trial (£1,950/patient), a screening trial prior to SCS implantation would be cost-saving. The proportion of patients having an unsuccessful screening trial would have to be ≥14.4% for current practice of a screening trial to be cost-saving. The findings from this budget impact analysis support the results of a recent UK multicenter randomized controlled trial (TRIAL-STIM) of a policy for the discontinuation of compulsory SCS screening trials, namely that such a policy would result in considerable cost-savings to healthcare systems.
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spelling pubmed-94861552022-09-21 Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis Duarte, Rui V. Houten, Rachel Nevitt, Sarah Brookes, Morag Bell, Jill Earle, Jenny Gulve, Ashish Thomson, Simon Baranidharan, Ganesan North, Richard B. Taylor, Rod S. Eldabe, Sam Front Pain Res (Lausanne) Pain Research Screening trials of spinal cord stimulation (SCS) prior to full implantation of a device are recommended by expert guidelines and international regulators. The current study sought to estimate the budget impact of a screening trial of SCS and the costs or savings of discontinuing the use of a screening trial. A budget impact analysis was performed considering a study population that reflects the size and characteristics of a patient population with neuropathic pain in England eligible for SCS. The perspective adopted was that of the NHS with a 5-year time horizon. The base case analysis indicate that a no screening trial strategy would result in cost-savings to the NHS England of £400,000–£500,000 per year. Sensitivity analyses were conducted to evaluate different scenarios. If ≥5% of the eligible neuropathic pain population received a SCS device, cost-savings would be >£2.5 million/year. In contrast, at the lowest assumed cost of a screening trial (£1,950/patient), a screening trial prior to SCS implantation would be cost-saving. The proportion of patients having an unsuccessful screening trial would have to be ≥14.4% for current practice of a screening trial to be cost-saving. The findings from this budget impact analysis support the results of a recent UK multicenter randomized controlled trial (TRIAL-STIM) of a policy for the discontinuation of compulsory SCS screening trials, namely that such a policy would result in considerable cost-savings to healthcare systems. Frontiers Media S.A. 2022-09-06 /pmc/articles/PMC9486155/ /pubmed/36147037 http://dx.doi.org/10.3389/fpain.2022.974904 Text en Copyright © 2022 Duarte, Houten, Nevitt, Brookes, Bell, Earle, Gulve, Thomson, Baranidharan, North, Taylor and Eldabe. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pain Research
Duarte, Rui V.
Houten, Rachel
Nevitt, Sarah
Brookes, Morag
Bell, Jill
Earle, Jenny
Gulve, Ashish
Thomson, Simon
Baranidharan, Ganesan
North, Richard B.
Taylor, Rod S.
Eldabe, Sam
Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title_full Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title_fullStr Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title_full_unstemmed Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title_short Screening trials of spinal cord stimulation for neuropathic pain in England—A budget impact analysis
title_sort screening trials of spinal cord stimulation for neuropathic pain in england—a budget impact analysis
topic Pain Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486155/
https://www.ncbi.nlm.nih.gov/pubmed/36147037
http://dx.doi.org/10.3389/fpain.2022.974904
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