Health Services Utilization and Payments in Patients With Cancer Pain: A Comparison of Intrathecal Drug Delivery vs. Conventional Medical Management

Neuromodulation. 2016 Feb;19(2):196-205. doi: 10.1111/ner.12384. Epub 2016 Jan 27.

Abstract

Introduction: To compare health services utilization and payments for cancer patients who received an implantable intrathecal drug delivery (IDD) system, consisting of a pump and catheter, vs. conventional medical management (CMM) for the treatment of cancer-related pain.

Methods: This retrospective claims-data analysis compared health services utilization and payments in a population of patients receiving either IDD or CMM for treatment of cancer pain. Patients were propensity score-matched 1:1 based on characteristics including, but not limited to, age, gender, cancer type, comorbid conditions, and health care utilization and payments.

Results: From a sample of 142 IDD patients and 3188 CMM patients who met all inclusion/exclusion criteria, 73 matched pairs were obtained. In the year following implant, IDD patients had a consistent trend of lower medical utilization, and total payments that were $3195 lower compared to CMM.

Conclusions: Despite the high initial cost of IDD, this analysis suggests that patients with IDD incur lower medical utilization and payments over the first year post-implant. Further analysis comprised of a larger, longitudinal sample would contribute to health economics and outcomes research, and assist with future practice guideline development.

Keywords: Cancer pain; conventional medical management; health services utilization; intrathecal drug delivery; retrospective study.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analgesics / administration & dosage*
  • Female
  • Humans
  • Infusion Pumps, Implantable / economics*
  • Injections, Spinal / economics
  • Injections, Spinal / methods
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Pain / etiology
  • Pain Management / economics*
  • Pain Management / methods
  • Patient Acceptance of Health Care
  • Propensity Score
  • Retrospective Studies

Substances

  • Analgesics