Effectiveness of electrical neuromodulation: an economic paradigm

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Pain Med. 2006 May-Jun;7 Suppl 1:S185-90.

Effectiveness of electrical neuromodulation: an economic paradigm.

Sitzman BT, Gallagher RM.

Advanced Pain Therapy, Forrest General Cancer Center, Hattiesburg,

Mississippi, USA.

ABSTRACT The last 10-15 years has witnessed a rapid growth and

advancement of electrical neuromodulation technologies: spinal cord

stimulation, peripheral nerve stimulation, deep brain stimulation,

and motor cortex stimulation. As the manuscripts in this Pain

Medicine supplement attest, there is strong evidence documenting the

efficacy and safety of electrical neuromodulation in the treatment of

many chronic, refractory pain conditions, including complex regional

pain syndromes, intractable angina pectoris, neuropathic extremity

pain, axial low back pain, atypical facial pain, certain visceral

pain syndromes, and others. Along with the growth in utilization of

electrical neuromodulation therapies, competitive pressures within

the healthcare industry have created the need for other healthcare

decision makers, specifically the government and third-party

insurance payers, to examine the overall effectiveness and costs of

electrical neuromodulation. Our objective was not to summarize the

results of cost analysis studies involving neuromodulation. Doing so

would be relatively simple. It is more important for the clinician to

understand the underlying problems in our current reimbursement

system. In doing so, we as physicians can better understand the

true " value " of electrical neuromodulation therapy from the

perspectives of the individual patient, the hospital administrator,

and the healthcare payer.