TY - JOUR
T1 - Screening trials of spinal cord stimulation for neuropathic pain in England-A budget impact analysis
AU - Duarte, Rui V
AU - Houten, Rachel
AU - Nevitt, Sarah
AU - Brookes, Morag
AU - Bell, Jill
AU - Earle, Jenny
AU - Gulve, Ashish
AU - Thomson, Simon
AU - Baranidharan, Ganesan
AU - North, Richard B
AU - Taylor, Rod S
AU - Eldabe, Sam
N1 - Copyright © 2022 Duarte, Houten, Nevitt, Brookes, Bell, Earle, Gulve, Thomson, Baranidharan, North, Taylor and Eldabe.
PY - 2022/9/6
Y1 - 2022/9/6
N2 - 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.
AB - 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.
U2 - 10.3389/fpain.2022.974904
DO - 10.3389/fpain.2022.974904
M3 - Article
C2 - 36147037
SN - 2673-561X
VL - 3
JO - Frontiers in pain research (Lausanne, Switzerland)
JF - Frontiers in pain research (Lausanne, Switzerland)
M1 - 974904
ER -