Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Sep;29(9):1021-1029.
doi: 10.18553/jmcp.2023.29.9.1021.

Health care resource utilization and costs in patients with painful diabetic neuropathy treated with 10 kHz spinal cord stimulation therapy

Rod S Taylor  1 , Shivanand P Lad  2 , Judith L White  3 , Thomas G Stauss  4 , Bridget E Healey  5   6 , Naomi C Sacks  5   7 , Ronaé McLin  8 , Sandeep Patil  9 , Michael J Jaasma  9 , David L Caraway  9 , Erika A Petersen  10
Affiliations
Randomized Controlled Trial

Health care resource utilization and costs in patients with painful diabetic neuropathy treated with 10 kHz spinal cord stimulation therapy

Rod S Taylor et al. J Manag Care Spec Pharm. 2023 Sep.

Abstract

BACKGROUND: Diabetic peripheral neuropathy, a common comorbidity of diabetes, is a neurodegenerative disorder that targets sensory, autonomic, and motor nerves frequently associated with painful diabetic neuropathy (PDN). PDN carries an economic burden as the result of reduced work and productivity. A recent multicenter randomized controlled trial, SENZA-PDN (NCT03228420), assessed the impact of high-frequency (10 kHz) spinal cord stimulation (SCS) on pain relief. The effects of high-frequency SCS on health care resource utilization and medical costs are not known. OBJECTIVE: To evaluate the effect of high-frequency (10 kHz) SCS on health care resource utilization (HRU) and medical costs in patients with PDN using data from the SENZA-PDN trial. METHODS: Participants with PDN were randomly assigned 1:1 to receive either 10 kHz SCS plus conventional medical management (CMM) (SCS treatment group) or CMM alone (CMM treatment group). Patient outcomes and HRU up to the 6-month follow-up are reported here. Costs (2020 USD) for each service was estimated based on publicly available Medicare fee schedules, Medicare claims data, and literature. HRU metrics of inpatient and outpatient contacts and costs are reported as means and SDs. Univariate and bivariate analyses were used to compare SCS and CMM treatment groups at 6 months. RESULTS: At 6-month follow up, the SCS arm experienced approximately half the mean rate of hospitalizations per patient compared with the CMM treatment group (0.08 vs 0.15; P = 0.066). The CMM treatment group's total health care costs per patient were approximately 51% higher compared with the SCS treatment group (equivalent to mean annual cost per patient of $9,532 vs $6,300). CONCLUSIONS: Our analysis of the SENZA-PDN trial indicates that the addition of 10 kHz SCS therapy results in lower rates of hospitalization and consequently lower health care costs among patients with PDN compared with those receiving conventional management alone.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Study Design: Patient Disposition
FIGURE 2
FIGURE 2
Study Design: Health Care Resource Utilization Study Visits
FIGURE 3
FIGURE 3
Estimated Annualized Average Costs per Patient by Encounter and Study Cohort
See this image and copyright information in PMC

References

    1. Feldman EL, Callaghan BC, Pop-Busui R, et al. . Diabetic neuropathy. Nat Rev Dis Primers. 2019;5(1):41. doi:10.1038/s41572-019-0092-1 - PubMed
    1. Sadosky A, Schaefer C, Mann R, et al. . Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: Results from a retrospective chart review and cross-sectional survey. Diabetes Metab Syndr Obes. 2013;6:79-92. doi:10.2147/dmso.S37415 - PMC - PubMed
    1. Sadosky A, Mardekian J, Parsons B, Hopps M, Bienen EJ, Markman J. Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy. J Diabetes Complications. 2015;29(2):212-7. doi:10.1016/j.jdiacomp.2014.10.013 - PubMed
    1. Shillo P, Sloan G, Greig M, et al. . Painful and painless diabetic neuropathies: What is the difference? Curr Diab Rep. 2019;19(6):32. doi:10.1007/s11892-019-1150-5 - PMC - PubMed
    1. daCosta DiBonaventura M, Cappelleri JC, Joshi AV. A longitudinal assessment of painful diabetic peripheral neuropathy on health status, productivity, and health care utilization and cost. Pain Med. 2011;12(1):118-26. doi:10.1111/j.1526-4637.2010.01012.x - PubMed

Publication types