Library Subscription: Guest
Begell Digital Portal Begell Digital Library eBooks Journals References & Proceedings Research Collections
Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2014011685
pages 173-183

Cost Effectiveness of a Novel 10 kHz High-Frequency Spinal Cord Stimulation System in Patients with Failed Back Surgery Syndrome (FBSS)

Lieven Annemans
Department of Public Health, Ghent University, Ghent, Belgium
Jean-Pierre Van Buyten
Multidisciplinary Pain Centre, AZ Nikolaas, St. Niklaas, Belgium
Thomas Smith
The Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdom
Adnan Al-Kaisy
The Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdom

ABSTRACT

Objectives: Spinal cord stimulation (SCS) is an effective method of relieving chronic intractable pain, and one of its key indications is failed back surgery syndrome (FBSS). The objective of the current study was to evaluate the cost effectiveness of 10 kHz high-frequency SCS (HF10 SCS) compared to conventional medical management (CMM), reoperation, and traditional nonrechargeable (TNR-SCS) and rechargeable SCS (TR-SCS). Methods: A health economic model of SCS in the United Kingdom was reproduced in the perspective of the health care system to simulate costs and quality adjusted life years (QALYs) over 15 years. In the model, both a decision tree and the Markov model were used to describe the health outcomes of the evaluated therapies. Results: HF10 SCS therapy showed a favorable incremental cost-effectiveness ratio (ICER) of £3,153 per QALY gained as compared to CMM and established dominance (less costly, more QALYs) compared to TNR-SCS (£8,802 per QALY vs. CMM) and TR-SCS (£5,101 per QALY vs. CMM). Conclusion: This first analysis of the cost effectiveness of HF10 SCS suggests that it is more cost effective and provides a greater number of QALYs than both TNR-SCS and TR-SCS.