High-frequency 10?kHz Spinal Cord Stimulation for Chronic Back and Leg Pain: Cost-consequence and Cost-effectiveness Analyses.

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.

SUBMITTER: Taylor RS 

PROVIDER: S-EPMC7671822 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature