Kalia Hemant, Thapa Bishnu, Staats Peter, Martin Patrick, Stetter Kori, Feldman Becca, Marci Carl
Center for Research & Innovation in Spine and Pain, Rochester, NY, USA.
Epidemiology Department, OM1, Inc., Boston, MA, USA.
Pain Manag. 2025 Jan;15(1):27-36. doi: 10.1080/17581869.2025.2449810. Epub 2025 Jan 6.
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.
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.
Patients with PNS using the micro-IPG had reduced HCRU, costs, and opioid use.
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。
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。
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%。
使用微型IPG的PNS患者的HCRU、成本和阿片类药物使用减少。
