Health Economic Considerations

Agencies like the FDA and European Medicines Agency (EMA) assess the safety and efficacy of devices, but traditionally cost-effectiveness was secondary. Due to healthcare budget constraints, the cost-effectiveness of treatments now significantly influences their adoption and insurance coverage.

IDD is expensive upfront, requires periodic refills, and can lead to complications. Therefore, evaluating its economic value based on outcomes is crucial and has been the subject of multiple economic evaluations and systematic reviews on use in cancer, non-cancer and spasticity patients.

Studies on IDD for conditions like cancer pain, chronic non-cancer pain, and spasticity^257-267 generally support its cost-effectiveness in well-selected patients when other treatments fail. Cost savings typically emerge over 2-3 years as hospitalizations and other healthcare needs decrease.

A major limitation in current IDD cost-effectiveness research is weak source data. Incorporating economic evaluations at the trial planning stage could strengthen future evidence.

Reprinted from Neuromodulation: Technology at the Neural Interface, Vol 27 / Issue 7, Timothy R Deer, Salim M Hayek, Jay S Grider, Jonathan M Hagedorn, Gladstone C McDowell 2nd Philip Kim, Denis Dupoiron, Vasudha Goel, Rui Duarte, Julie G Pilitsis, Michael S Leong, Jose De Andrés, Christophe Perruchoud, Harry Sukumaran, Alaa Abd-Elsayed, Michael Saulino, Dennis Patin, Lawrence R Poree, Natalie Strand, Karina Gritsenko, Jill A Osborn, Ivano Dones, Anjum Bux, Jay M Shah, Brad L Lindsey, Erik Shaw, Tony L Yaksh, Robert M Levy, The Polyanalgesic Consensus Conference (PACC)®: Intrathecal Drug Delivery Guidance on Safety and Therapy Optimization When Treating Chronic Noncancer Pain, Pages 1107-1139., Copyright (2024), with permission from the International Neuromodulation Society.