ESRA19-0086 Costs associated with subcutaneous peripheral nerve stimulation: data from the subqstim RCT

Background and aims The SubQStim study reported subcutaneous nerve stimulation (SQS) plus optimized medical management (OMM) was more effective in reducing back pain than OMM alone in patients with FBSS.1 Here we present estimates of healthcare resource use (HCU) and costs within the study. Methods Ethics committee approval was obtained for each site. Using data collected within-trial, we present descriptive analysis across categories of HCU (pain medication, hospital costs, healthcare visits), as well as device implantation, system modifications, and device deficiencies/adverse events. Combining HCU data with published UK cost data,2 3 we estimated baseline costs (3-months pre-baseline) and over 9-months follow-up for the OMM (N=60) and SQS+OMM (N=56) treatment arms. Results SQS+OMM subjects utilized fewer health care visits over the 9-month period than OMM group, with costs of £1,082 and £1,238 respectively. Monthly medication costs reduced in the SQS+OMM group (£18 pre-baseline to £17 during the study) and increased in the OMM group (from £23 to £26). Overall cost per patient was £1,693 in the OMM group and £18,403 in the SQS+OMM group, with 89% of the total cost of SQS+OMM group being driven by the device and procedural costs. Conclusions Compared to OMM alone, adding SQS may lead to reductions in HCU and medication costs, but do not offset the up-front device and implantation costs within a 9-month time frame. Further analyses are needed to assess the longer-term economic impact of SQS therapy relative to the initial device costs. References Eldabe, et al. Neuromodulation 2018;DOI:10.1111/ner.12784. NHS Payment by Results Tariffs, 2017–18. British National Formulary, No.75. 2018.