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

Duarte, R. V. et al. (2022) Screening trials of spinal cord stimulation for neuropathic pain in England—a budget impact analysis. Frontiers in Pain Research, 3, 974904. (doi: 10.3389/fpain.2022.974904) (PMID:36147037) (PMCID:PMC9486155)

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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.

Item Type:Articles
Additional Information:This research was funded by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) (project number: NIHR201444).
Keywords:Budget impact analysis, spinal cord stimulation, screening trials, neuropathic pain, cost savings.
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Duarte, R. V., Houten, R., Nevitt, S., Brookes, M., Bell, J., Earle, J., Gulve, A., Thomson, S., Baranidharan, G., North, R. B., Taylor, R. S., and Eldabe, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Frontiers in Pain Research
Publisher:Frontiers Media
ISSN (Online):2673-561X
Copyright Holders:Copyright © 2022 Duarte, Houten, Nevitt, Brookes, Bell, Earle, Gulve, Thomson, Baranidharan, North, Taylor and Eldabe
First Published:First published in Frontiers in Pain Research 3: 974904
Publisher Policy:Reproduced under a Creative Commons License

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