Cost effectiveness of implantable devices versus tunneled catheters

• Published in: Current pain and headache reports 1998-09, Vol.2 (3), p.157-162
• Main Authors: Erdine Serdar, Talu, G K
• Format: Article
• Language: English
• Subjects: Economic analysis; Pain management
• ISSN: 1531-3433; 1534-3081
• DOI: 10.1007/s11916-998-0013-6

Issues of health policy on pain management cover the areas of cost, regulation of care, ethical, and legal matters. Pain management is growing not only on a scientific basis but also as a business. Although cost issues are gaining more attention in the pain field, only a small number of studies have been reported.The development of new techniques for the management of pain has opened up multiple treatment options that vary in cost.The appropriate selection criteria are very important and there is still no consensus on guidelines. Several models have been proposed to analyze the cost issues in pain management, such as agency, self-interest, or medical ethics models. There are four methods of economic analysis: cost-minimization, cost-utility, cost-benefit, and cost-effectiveness analysis.There are several difficulties in dealing with cost effectiveness.The studies generally rely on scenarios or computer-based simulations.There are studies that compare exteriorized systems with implanted infusion pumps. We compared the exteriorized system with the mechanical pump, Algomed (Medtronic, Minneapolis, MN). We also compared bolus administration through an epidural port with the Algomed system. In all the studies it appeared that within 3 to 7 months the implantable systems became cost-effective.