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. 2019 Sep 17;11(9):e5685.
doi: 10.7759/cureus.5685.

Economic Inequities in the Application of Neuromodulation Devices

James Leiphart  1 , Megan Barrett  1 , Mahesh B Shenai  1
Affiliations

Economic Inequities in the Application of Neuromodulation Devices

James Leiphart et al. Cureus. .

Abstract

Background There is a significant upfront cost for the use of neuromodulation devices. The high cost of these devices may lead to disproportionate application in geographical regions with different levels of financial resources. The purpose of this study was to determine if there is geographic based economic inequity in the application of neuromodulation devices in the United States. Methods Population and average household income data by county from the year 2010 were obtained from publicly available databases on the US Census website. The number of stimulators sold by county in the years 2009 and 2010 were provided by two of the four neuromodulation companies with commercially available products. Pearson correlation and t-test statistics were performed. Results Of the 3142 U.S. counties analyzed, only 689 placed neuromodulation devices during this period of time. There was a difference in average household income between counties with device implants ($49,663) and counties with no device implants ($41,314), which was statistically significant (p<0.001). Conclusion Analysis of neuromodulation devices placed in 2009 and 2010 from 50% of neuromodulation companies demonstrated that there was an income disparity between counties in which implantation of devices occurred and counties in which there were no device implantations.

Keywords: economic inequity; household income; medical economics; neuromodulation; spinal cord stimulation; vagal nerve stimulation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Average household income
Comparison of average household income in counties implanting stimulators, versus counties not implanting stimulators
Figure 2
Figure 2. Number of implanted stimulators per county, versus the average household income
Scatter plot depicting average household income and the number of stimulators implanted in 2009-2010, for each of the 689 counties included in the study
Figure 3
Figure 3. Implanted stimulators per 1000 people, versus average household income
Scatter plot depicting the incidence (per 1000) of neurostimulator implantation in 2009-2010, versus average household income for each of the 689 counties included in the study
See this image and copyright information in PMC

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