Conflict of Interest: The authors disclose that Dr. Fisher is the medical director for Pentec Health, Inc. and a consultant and speaker for Medtronic, Inc., whose devices are the subject of this article. Dr. Thrasher disclosed no conflicts of interest.
Editor’s Choice: Retrospective Study
Societal Costs of Intrathecal Drug Delivery Systems—An Administrative Analysis Based on Patient Claims
Article first published online: 19 FEB 2013
© 2013 International Neuromodulation Society
Neuromodulation: Technology at the Neural Interface
Volume 16, Issue 3, pages 261–265, May/June 2013
How to Cite
2013. Societal Costs of Intrathecal Drug Delivery Systems—An Administrative Analysis Based on Patient Claims.Neuromodulation 2013; e-pub ahead of print. DOI: 10.1111/ner.12029, .
For more information on author guidelines, an explanation of our peer review process, and conflict of interest informed consent policies, please go to http://www.wiley.com/bw/submit.asp?ref=1094-7159&site=1
Source(s) of financial support: This study was funded by Pentec Health, Inc. (Boothwyn, Pennsylvania, USA).
- Issue published online: 4 JUN 2013
- Article first published online: 19 FEB 2013
- Manuscript Accepted: 31 DEC 2012
- Manuscript Revised: 20 NOV 2012
- Manuscript Received: 13 AUG 2012
- Pentec Health, Inc.
- chronic pain;
To quantify the overall and disaggregated societal costs of intrathecal drug delivery systems (IDDSs) in the treatment of pain and spasticity in the United States.
Materials and Methods
A retrospective review of medical and pharmacy claims was performed on patients with IDDS. Patients were divided into three cohorts according to the conditions that their IDDSs were intended to treat pain, spasticity, or both. Patients also were stratified according to whether or not cost data were available for the implantation of their IDDSs. Total societal costs that were directly attributable to pain or spasticity were summarized, and medical/pharmaceutical encounters were enumerated.
N = 38,951 patients (52.7% women, age 54.1 ± 14.1 years) with IDDSs were identified and included in this study. IDDS patients have an average of 34.0–52.7 (depending on cohort) medical encounters per year, of which an average of 6.3–10.1 is attributable to the condition their IDDS is intended to treat. The average societal cost of the attributable encounters is $12,233 to $20,049 per patient year (inflation-adjusted 2011 U.S. dollars); however, the distribution of these costs is extremely skewed in the positive direction. Inpatient treatment accounts for 65.9% of the societal costs incurred by IDDS patients.
The societal costs for IDDS patients are high and extremely variable. A relatively small number of patients made an extreme number of medical encounters and represent a heavy societal cost burden. In order to reduce the growing societal cost of chronic pain and spasticity treatment, measures should be taken to reduce the resource utilization and costs of the most challenging patients.