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使用微型植入式脉冲发生器系统的外周神经刺激的真实世界医疗保健利用情况和成本。

Real-world healthcare utilization and costs of peripheral nerve stimulation with a micro-IPG system.

作者信息

Kalia Hemant, Thapa Bishnu, Staats Peter, Martin Patrick, Stetter Kori, Feldman Becca, Marci Carl

机构信息

Center for Research & Innovation in Spine and Pain, Rochester, NY, USA.

Epidemiology Department, OM1, Inc., Boston, MA, USA.

出版信息

Pain Manag. 2025 Jan;15(1):27-36. doi: 10.1080/17581869.2025.2449810. Epub 2025 Jan 6.

Abstract

AIM

To characterize real-world healthcare resource utilization (HCRU) and costs in adults with chronic pain of peripheral nerve origin treated with peripheral nerve stimulation (PNS) using the micro-implantable pulse generator (IPG).

MATERIALS & METHODS: This retrospective observational study (9/1/19-1/31/23) linked patients from the Nalu medical database to the OM1 Real-World Data Cloud (RWDC). Eligible patients received the micro-IPG implant for PNS, were identifiable in both databases, and had ≥ 12 months of RWDC pre/post-implantation claims data. Primary outcomes were all-cause HRCU and medical costs (12 months pre- and post-implantation); secondary outcomes were all-cause pharmacy costs, including opioids, over the same time.

RESULTS

Patients ( = 122) had a higher mean (standard deviation; SD) number of outpatient visits pre-implantation (5.7 [5.4]) than post-implantation (4.9 [5.7]). Mean (SD) total medical costs were 50% lower, from $27,493 ($44,756) to $13,717 ($23,278). Median (first-third quartile [Q1-Q3]) medical costs were 57% lower, from $11,809 ($4,075-$31,788) to $5,094 ($1,815-$13,820). Mean (SD) pharmacy costs ( = 77) were higher post-implantation ($22,470 [$77,203]) than pre-implantation ($20,092 [$64,132]), while median (Q1-Q3) costs were lower (from $2,708 [$222 -11,882] to $2,122 [$50-9,370]). Post-implantation, the proportion of patients using opioids was 31.4% lower.

CONCLUSION

Patients with PNS using the micro-IPG had reduced HCRU, costs, and opioid use.

摘要

目的

使用微型植入式脉冲发生器(IPG)对外周神经刺激(PNS)治疗的外周神经源性慢性疼痛成人患者的真实世界医疗资源利用(HCRU)和成本进行特征描述。

材料与方法

这项回顾性观察研究(2019年9月1日至2023年1月31日)将Nalu医疗数据库中的患者与OM1真实世界数据云(RWDC)进行了关联。符合条件的患者接受了用于PNS的微型IPG植入,在两个数据库中均可识别,并且在植入前/后有≥12个月的RWDC索赔数据。主要结局是全因HRCU和医疗成本(植入前和植入后12个月);次要结局是同期全因药房成本,包括阿片类药物。

结果

患者(n = 122)植入前的门诊就诊平均次数(标准差;SD)(5.7 [5.4])高于植入后(4.9 [5.7])。平均(SD)总医疗成本降低了50%,从27493美元(44756美元)降至13717美元(23278美元)。中位数(第一-第三四分位数[Q1-Q3])医疗成本降低了57%,从11809美元(4075美元-31788美元)降至5094美元(1815美元-13820美元)。平均(SD)药房成本(n = 77)植入后(22470美元[77203美元])高于植入前(20092美元[64132美元]),而中位数(Q1-Q3)成本较低(从2708美元[222美元-11882美元]降至2122美元[50美元-9370美元])。植入后,使用阿片类药物的患者比例降低了31.4%。

结论

使用微型IPG的PNS患者的HCRU、成本和阿片类药物使用减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b882/11801342/35d5d425c6de/IPMT_A_2449810_F0001_OC.jpg

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