Intrathecal baclofen pumps may save in the long run

Saulino M, Guillemette S, Leier J, Hinnenthal J. Medical Cost Impact of Intrathecal Baclofen Therapy for Severe Spasticity.
Neuromodulation. 2014 Aug 21. doi: 10.1111/ner.12220. [Epub ahead of print]

OBJECTIVES:To evaluate the economic effects of intrathecal baclofen (ITB) for patients with severe spasticity based on costs of care before and after implantation of an intrathecal drug delivery system.
MATERIALS AND METHODS: An actuarial projection of post-implant experience in the absence of ITB intervention was used to simulate a continued conventional medical management protocol (ITB-free) by assuming a reasonable trend rate based on health-care industry standards. Cost projections were developed over a 30-year time horizon at various reimplantation rates. The model was informed by retrospective analysis of commercial administrative claims data from 409 paediatric and adult spasticity patients who received a pump implant (ITB-experienced) within a 3-year service period (January 2006 to January 2009). Common indications associated with pump implant included multiple sclerosis (N = 124), cerebral palsy (N = 131), and spinal cord injury (N = 40).
RESULTS: ITB was less costly than the conventional protocol over our baseline implantation cycle. Costs in the month of implant and in the year following were cumulatively $26,375 more than with the conventional protocol. However, ITB financial break-even occurs between the second and third years post-implant. The lifetime analysis indicates that savings for ITB are $8009 per patient per year compared with conventional therapy. Most of the savings are derived from reductions in inpatient admissions, physician office visits, and outpatient physiotherapy.
CONCLUSIONS: The results suggest that spasticity patients receiving ITB would expect to experience a reduction in cumulative future medical costs relative to anticipated costs in the absence of a pump implant. This finding complements the existing literature on the cost-effectiveness of ITB.
Whilst you can read the post, it is interesting that the study indicates the cost of intrathecal pumps. If used effectively they can be revolutionary in helping people wean themselves off other medications and lifting the cognitive dulling that these medications can cause. This study shows that high upfront costs can be offset by future reduced costs. Will this also be the case with high cost induction therapies that may save down the line. Only time will tell.

CoI. We are developing alternatives to baclofen

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  • I know someone with stiff person syndrome who has just had this procedure and the outcome seems positive. He's off most his meds and reports less pain.

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