Cost-effectiveness of intraspinal drug delivery for chronic pain

Nguyen, H. C.; Hassenbusch, Samuel J.

doi:10.1016/j.spmd.2004.01.002

Cited by 2 publications

(2 citation statements)

References 3 publications

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“… 7 The implantable intrathecal morphine pump (ITMP), which was invented in the 21st century, manages pain in patients with terminal cancer or idiopathic chronic pain better than oral narcotics due to its ability to continuously deliver morphine to the intrathecal space at a constant rate. 8 9 The first surgically-implanted ITMP in Korea was in 2008, to treat cancer and chronic pain. 10 …”

Section: Introductionmentioning

confidence: 99%

Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea

et al. 2016

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PurposeIntrathecal morphine pump (ITMP) infusion therapy is efficient in managing malignant and nonmalignant chronic pain refractory to standard treatment. However, the high cost of an ITMP is the greatest barrier for starting a patient on ITMP infusion therapy. Using the revised Korean reimbursement guidelines, we investigated the cost effectiveness of ITMP infusion therapy and conducted a patient survey.Materials and MethodsA retrospective chart review of 12 patients who underwent ITMP implantation was performed. Morphine dose escalation rates were calculated, and numeric rating scale (NRS) scores were compared before and after ITMP implantation. We surveyed patients who were already using an ITMP as well as those who were candidates for an ITMP. All survey data were collected through in-person interviews over 3 months. Data on the cost of medical treatment were collected and projected over time.ResultsThe NRS score decreased during the follow-up period. The median morphine dose increased by 36.9% over the first year, and the median time required to reach a financial break-even point was 24.2 months. Patients were more satisfied with the efficacy of ITMP infusion therapy than with conventional therapy. The expected cost of ITMP implantation was KRW 4000000–5000000 in more than half of ITMP candidates scheduled to undergo implantation.ConclusionThe high cost of initiating ITMP infusion therapy is challenging; however, the present results may encourage more patients to consider ITMP therapy.

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Section: Introductionmentioning

confidence: 99%

Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea

et al. 2016

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“…Another study that compared the costs of ITDD to those of external infusion pumps was excluded because 60% of the patients had cancer pain and the cost comparison was not presented for each patient group . Three of the 9 studies were narrative reviews of other economic evaluations already included in this review, and were therefore excluded . Staats et al did not report any cost data, and the conference abstract by Sawyer and Blowey presented no information on how the total cost estimate (£460,000 for all the patients in the study, equivalent to £24,000 per patient) was calculated.…”

Section: Resultsmentioning

confidence: 99%

Intrathecal Drug Delivery Systems for the Management of Chronic Noncancer Pain: A Systematic Review of Economic Evaluations

et al. 2017

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Introduction: Intrathecal drug delivery (ITDD) systems are an option for the management of patients with chronic non-cancer pain, cancer pain and spasticity. Concerns over their invasiveness and high initial costs have led National Health Service (NHS) England to decommission ITDD for patients with chronic noncancer pain. However, the extent to which this decision is in line with existing economic evidence is unclear.To address this question, we will carry out a systematic review to identify and evaluate the existing evidence on the cost-effectiveness of ITDD for chronic non-cancer pain.Methods and analysis: A high-sensitivity search strategy will be employed in Cochrane Library, MEDLINE, EMBASE, Web of Science, NHS EED, DARE and HTA. Database searches will be complemented by additional searching techniques. Screening of the results will be performed by 2 reviewers independently using predetermined inclusion and exclusion criteria. Full and partial economic evaluations will be included. Data extraction will be carried out using a form created for the purposes of this review. Quality assessment of all included studies will be performed using recommended checklists.Ethics and dissemination: Ethical approval is not required as primary data will not be collected. Findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO registration number:CRD42016035266.

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Cost-effectiveness of intraspinal drug delivery for chronic pain

Cited by 2 publications

References 3 publications

Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea

Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea

Intrathecal Drug Delivery Systems for the Management of Chronic Noncancer Pain: A Systematic Review of Economic Evaluations

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