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复杂性区域疼痛综合征的脊髓刺激疗法:成本效益模型综述

SCS for CRPS: A Review of Cost-Effectiveness Models.

作者信息

Briggi Daniel R, Reilly James, Garcia Josiel, Kupperman Wyatt

机构信息

H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.

Johns Hopkins University, Baltimore, MD, USA.

出版信息

Curr Pain Headache Rep. 2025 Apr 21;29(1):75. doi: 10.1007/s11916-025-01388-x.

DOI:10.1007/s11916-025-01388-x
PMID:40257598
Abstract

PURPOSEOF REVIEW

The provision of a review of current literature on the cost-effectiveness of employing SCS in the treatment of CRPS.

RECENT FINDINGS

Four studies were included in this review, with authorship in the United States, Canada, Europe, and Australia. Each study individually supported the cost-effectiveness of SCS in the treatment of CRPS, with the incremental cost of one quality-adjusted life year found to be AUD 2,321 - USD 22,084, all below a willingness to pay estimated at USD 50,000. One of the four studies was rated American Academy of Neurology (AAN) Grade II, three of the four studies were rated AAN Grade III, and an overall Class C evaluation was assigned to this evidence. SCS can be cost-effective in the treatment of patients with CRPS when considering a time horizon of at least ten years. Current evidence, however, remains weak and less invasive options remain first-line.

摘要

综述目的

对目前关于采用脊髓刺激(SCS)治疗复杂性区域疼痛综合征(CRPS)的成本效益的文献进行综述。

最新发现

本综述纳入了四项研究,作者分别来自美国、加拿大、欧洲和澳大利亚。每项研究均单独支持SCS治疗CRPS的成本效益,发现每增加一个质量调整生命年的增量成本为2321澳元至22084美元,均低于估计的50000美元的支付意愿。四项研究中有一项被评为美国神经病学学会(AAN)II级,四项研究中有三项被评为AAN III级,该证据整体被评为C级。当考虑至少十年的时间范围时,SCS治疗CRPS患者可能具有成本效益。然而,目前的证据仍然薄弱,侵入性较小的选择仍然是一线治疗方法。

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本文引用的文献

1
Complex regional pain syndrome: advances in epidemiology, pathophysiology, diagnosis, and treatment.复杂性区域疼痛综合征:流行病学、病理生理学、诊断和治疗的进展。
Lancet Neurol. 2024 May;23(5):522-533. doi: 10.1016/S1474-4422(24)00076-0.
2
Real-World Cost-Effectiveness Analysis of Spinal Cord Stimulation vs Conventional Therapy in the Management of Failed Back Surgery Syndrome.脊髓刺激与传统疗法治疗腰椎手术失败综合征的真实世界成本效益分析
J Pain Res. 2021 Sep 24;14:3025-3032. doi: 10.2147/JPR.S326092. eCollection 2021.
3
Understanding the global measurement of willingness to pay in health.
了解全球范围内健康领域支付意愿的衡量情况。
J Mark Access Health Policy. 2020 Feb 15;8(1):1717030. doi: 10.1080/20016689.2020.1717030. eCollection 2020.
4
Cost-Effectiveness of Dorsal Root Ganglion Stimulation or Spinal Cord Stimulation for Complex Regional Pain Syndrome.背根神经节刺激或脊髓刺激治疗复杂性区域疼痛综合征的成本效益分析。
Neuromodulation. 2021 Jun;24(4):708-718. doi: 10.1111/ner.13134. Epub 2020 Mar 9.
5
Prevalence of common causes of neuropathic pain in Korea: population-based observational study.韩国神经性疼痛常见病因的患病率:基于人群的观察性研究。
J Int Med Res. 2020 Jul;48(7):300060519888102. doi: 10.1177/0300060519888102. Epub 2019 Nov 28.
6
Long-term Cost Utility of Spinal Cord Stimulation in Patients with Failed Back Surgery Syndrome.脊髓刺激治疗失败性背部手术综合征患者的长期成本效用。
Pain Physician. 2017 Sep;20(6):E797-E805.
7
Complex regional pain syndrome type 1 predictors - Epidemiological perspective from a national database analysis.复杂性区域疼痛综合征 1 型预测因素——国家数据库分析的流行病学视角。
J Clin Anesth. 2017 Jun;39:34-37. doi: 10.1016/j.jclinane.2017.03.027. Epub 2017 Mar 23.
8
Updating cost-effectiveness--the curious resilience of the $50,000-per-QALY threshold.更新成本效益——每质量调整生命年5万美元阈值令人好奇的韧性。
N Engl J Med. 2014 Aug 28;371(9):796-7. doi: 10.1056/NEJMp1405158.
9
Cost-effectiveness of spinal cord stimulation therapy in management of chronic pain.脊髓刺激疗法治疗慢性疼痛的成本效益分析。
Pain Med. 2013 Nov;14(11):1631-49. doi: 10.1111/pme.12146. Epub 2013 May 24.
10
The cost-effectiveness of spinal cord stimulation for complex regional pain syndrome.脊髓刺激治疗复杂性区域疼痛综合征的成本效益。
Value Health. 2010 Sep-Oct;13(6):735-42. doi: 10.1111/j.1524-4733.2010.00744.x. Epub 2010 Jun 7.