Pain Therapy with Spinal Cord Stimulation (SCS): Patient Characteristics and Healthcare Cost Implications Comparing Early and Late Therapy Start


Bischoff-Everding C1, Jähnichen G2, Kuhlmann H3, Straub V4, Libutzki B5, Luecke T6
1HGC Healthcare Consultants GmbH, Stuttgart, BW, Germany, 2Department of Spinal Surgery, Roland Hospital Bremen, Bremen, Germany, 3inspiring-health GmbH, Bremen, Germany, 4HGC Healthcare Consultants GmbH, Düsseldorf, Germany, 5HGC Healthcare Consultants GmbH, Dusseldorf, Germany, 6Franziskus Hospital Linz-Remagen, Remagen, Germany


Chronic pain heavily impacts the quality of life and is associated with high costs for health insurances. When conservative treatment and back surgery fail, SCS is currently often a second-line treatment to reduce pain. The aim of the study was to identify characteristics and healthcare costs of SCS patients and compare those for patients with an early vs. a late start of the SCS therapy.


A German health insurance claims data analysis was conducted based on an anonymized, representative sample of the German population. Patients with SCS therapy were identified in 2016/2017 and observed for three years prior to SCS therapy, stratified into patients with early vs. late SCS therapy start. Previously published data was used to compare rechargeable (RC) and non-rechargeable (NRC) neurostimulators three years after SCS therapy start.


100 patients were identified with initial SCS after failed back surgery. Average healthcare costs per patient were at €36,150 in three years prior to SCS therapy; patients treated early showed €7,886 (-20%) lower healthcare costs compared to those with a late therapy start. Patients with RC showed lower costs three years after SCS therapy than before. Patients with NRC showed an increase in costs three years after SCS therapy.


Early SCS therapy using rechargeable neurostimulators in patients with chronic pain and failed back surgery suggests benefits for both patient and payer.

Conference/Value in Health Info

2021-11, ISPOR Europe 2021, Copenhagen, Denmark

Value in Health, Volume 24, Issue 12, S2 (December 2021)




Economic Evaluation, Medical Technologies, Real World Data & Information Systems

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis, Health & Insurance Records Systems, Medical Devices


Multiple Diseases

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