New DRG technology has improved battery life, which we expect to make DRG more cost-effective compared to both CMM and SCS in the future.Ĭhronic pain complex regional pain syndrome conventional medical management cost-effectiveness dorsal root ganglion stimulation incremental cost-effectiveness ratio neuromodulation quality-adjusted life years spinal cord stimulation. DRG accrued higher cost due to higher conversion from trial to permanent implant and shorter battery life, but DRG was the most beneficial therapy due to more patients receiving permanent implants and experiencing higher quality of life compared to SCS. In the base case, ICER for DRG v SCS was $68,095/QALY.ĭRG and SCS are cost-effective treatments for chronic pain secondary to CRPS-I and II compared to CMM. Both DRG stimulation ($34,695 per QALY) and SCS ($22,084 per QALY) were cost-effective compared to CMM.
Willingness-to-pay thresholds of $50,000/QALY and $100,000/QALY were used to define highly cost-effective and cost-effective therapies.īoth DRG and SCS provided an increase in QALYs (4.96 ± 1.54 and 4.58 ± 1.35 QALYs, respectively) and an increase in costs ($153,992 ± $36,651 and $128,269 ± $27,771, respectively) compared to CMM (3.58 ± 0.91 QALYs, $106,173 ± $27,005) over the ten-year model lifetime. dollars per gain in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio (ICER) was reported as cost in 2017 U.S. Cost-effectiveness was evaluated using a Markov cohort model with ten-year time horizon from the U.S. The retrospective cost-utility analysis combined ACCURATE study data with claims data to compare cost-effectiveness between DRG stimulation, SCS, and CMM. This analysis compares cost-effectiveness of three modalities of treatment for CRPS, namely DRG stimulation, SCS, and comprehensive medical management (CMM). conventional spinal cord stimulation (SCS) in complex regional pain syndrome (CRPS-I and II) of the lower extremities. ACCURATE, a randomized controlled trial, compared safety and effectiveness of stimulation of the dorsal root ganglion (DRG) vs.