Costs and cost-effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome: An observational study in a workers compensation population

William Hollingworth, Judith A. Turner, Nicky J. Welton, Bryan A. Comstock, Richard (Rick) Deyo

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Study Design: Prospective cohort study. Objective: We estimated the cost-effectiveness of spinal cord stimulation (SCS) among workers compensation recipients with failed back surgery syndrome (FBSS). Summary of Background Data: Randomized controlled trial (RCT) evidence suggests that SCS is more effective at 6 months than medical management for patients with FBSS. However, procedure costs are high and workers compensation claimants often have worse outcomes than other patients. Methods: We enrolled 158 FBSS patients receiving workers compensation into three treatment groups: trial SCS with or without permanent device implant (n = 51), pain clinic (PC) evaluation with or without treatment (n = 39), and usual care (UC; n = 68). The primary outcome was a composite measure of pain, disability and opioid medication use. As reported previously, 5% of SCS patients, 3% of PC patients and 10% of UC patients achieved the primary outcome at 24 months. Using cost data from administrative databases, we calculated the cost-effectiveness of SCS, adjusting for baseline covariates. Results: Mean medical cost per SCS patient over 24 months was $52,091. This was $17,291 (95% confidence intervals [CI], $4100-30,490) higher than in the PC group and $28,128 ($17,620-38,630) higher than in the UC group. Adjusting for baseline covariates, the mean total medical and productivity loss costs per patient of the SCS group were $20,074 ($3840-35,990) higher than those of the PC group and $29,358 ($16,070-43,790) higher than those of the UC group. SCS was very unlikely (

Original languageEnglish (US)
Pages (from-to)2076-2083
Number of pages8
JournalSpine
Volume36
Issue number24
DOIs
StatePublished - Nov 15 2011

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Failed Back Surgery Syndrome
Spinal Cord Stimulation
Workers' Compensation
Cost-Benefit Analysis
Observational Studies
Costs and Cost Analysis
Pain Clinics
Population
Opioid Analgesics
Cohort Studies
Randomized Controlled Trials
Databases
Prospective Studies
Confidence Intervals
Pain
Equipment and Supplies

Keywords

  • cost-benefit analysis
  • cost-effectiveness
  • failed back surgery syndrome
  • spinal cord stimulation
  • workers compensation .

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Costs and cost-effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome : An observational study in a workers compensation population. / Hollingworth, William; Turner, Judith A.; Welton, Nicky J.; Comstock, Bryan A.; Deyo, Richard (Rick).

In: Spine, Vol. 36, No. 24, 15.11.2011, p. 2076-2083.

Research output: Contribution to journalArticle

Hollingworth, William ; Turner, Judith A. ; Welton, Nicky J. ; Comstock, Bryan A. ; Deyo, Richard (Rick). / Costs and cost-effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome : An observational study in a workers compensation population. In: Spine. 2011 ; Vol. 36, No. 24. pp. 2076-2083.
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