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The following is a summary of “Cost Savings in Chronic Pain Patients Initiating Peripheral Nerve Stimulation (PNS) with a 60-Day PNS Treatment,” published in the November 2024 issue of Pain by Dickerson et al.
Researchers conducted a retrospective study to assess the financial impact on healthcare payers when individuals with chronic pain initiated a 60-day percutaneous peripheral nerve stimulation (PNS) treatment compared to a conventional brief PNS trial (PNS-BT) followed by a permanently implanted PNS system (PNS-PI).
They analyzed Centers for Medicare & Medicaid Services (CMS) fee-for-service (FFS) data to identify individuals with at least 12 months of follow-up (median 26.4 months) who started PNS with either 60-Day PNS or PNS-BT. An economic decision tree model estimated payer costs for each group. Clinical response to 60-Day PNS was reviewed retrospectively using anonymized outcomes from a national real-world database, focusing on those aged 65 and older implanted with a 60-day percutaneous PNS system. A Monte Carlo simulation with 10,000 iterations generated 95% confidence intervals, accounting for variability in treatment outcomes and costs.
The results showed that 18% (229/1265) of individuals in the 60-Day PNS group transitioned to a PNS-PI, with a 4% explant rate (10/229). In the PNS-BT group, 41% (1140/2811) received permanent implants, with a 7% explant rate (77/1140). The weighted average PNS-related costs were lower in the 60-Day PNS cohort [US$17,344; 95% CI: $16,168–$18,527] compared to the PNS-BT (US$24,392; 95% CI: $22,865–$25,941). The total cost per successful outcome also favored 60-Day PNS (US$25,228 vs US$64,502) as an initial PNS treatment approach.
Investigators concluded that patients with chronic pain requiring PNS, initiating a 60-day treatment were more cost-effective compared to a brief conventional trial.
Source: link.springer.com/article/10.1007/s40122-024-00677-4
