Real-world healthcare utilization and costs of peripheral nerve stimulation with a micro-IPG system.

Aim: To characterize real-world healthcare resource utilization (HCRU) and costs in adults with chronic pain of peripheral nerve origin treated with peripheral nerve stimulation (PNS) using the micro-implantable pulse generator (IPG).

Materials & methods: This retrospective observational study (9/1/19-1/31/23) linked patients from the Nalu medical database to the OM1 Real-World Data Cloud (RWDC). Eligible patients received the micro-IPG implant for PNS, were identifiable in both databases, and had ≥ 12 months of RWDC pre/post-implantation claims data. Primary outcomes were all-cause HRCU and medical costs (12 months pre- and post-implantation); secondary outcomes were all-cause pharmacy costs, including opioids, over the same time.

Results: Patients (N = 122) had a higher mean (standard deviation; SD) number of outpatient visits pre-implantation (5.7 [5.4]) than post-implantation (4.9 [5.7]). Mean (SD) total medical costs were 50% lower, from $27,493 ($44,756) to $13,717 ($23,278). Median (first-third quartile [Q1-Q3]) medical costs were 57% lower, from $11,809 ($4,075-$31,788) to $5,094 ($1,815-$13,820). Mean (SD) pharmacy costs (n = 77) were higher post-implantation ($22,470 [$77,203]) than pre-implantation ($20,092 [$64,132]), while median (Q1-Q3) costs were lower (from $2,708 [$222 -11,882] to $2,122 [$50-9,370]). Post-implantation, the proportion of patients using opioids was 31.4% lower.

Conclusion: Patients with PNS using the micro-IPG had reduced HCRU, costs, and opioid use.