OBJECTIVES:

Diabetic neuropathy (DN) is a common complication of diabetes mellitus. Patients with DN who suffer from severe pain have poor quality of life and their treatment is associated with higher costs. Spinal cord stimulation (SCS) is a therapy option when conservative treatment approaches failed. The aim of this study was to present costs for patients with painful diabetic neuropathy (PDN), as well as to model the impact of SCS device implantation in patients with PDN on potential cost savings from the perspective of the statutory health insurance (SHI) funds in Germany.

METHODS:

We used input data from an anonymized, age- and sex-adjusted health claims database including approximate 4.9 million SHI-insured persons to calculate the number of DN patients suffering from PDN and to derive detailed cost data (inpatient, outpatient, or sick pay). We assumed therapy success of SCS device implantation of 85% (following Peterson et al. 2021) leading in pain relief. An inflation rate of 2% was used for the calculation of costs in the follow-up. Costs per patient over a period of 5 years were compared between the situation with and without SCS device

RESULTS:

The average costs per patient were 24,803€ for PDN, 42,887€ for PDN with SCS therapy in the starting year of SCS, mainly driven by the costs of device implantation (~70%), and 10,910€ for non-PDN. Based on our assumptions, we calculated additional costs per patient of 18,778€ in the starting year of SCS therapy due to costs of device implantation. From the third year onwards, cost savings were modelled when PDN patients are treated with SCS (year 3: 4,122€ cost savings per patient).

CONCLUSIONS:

The results of the budget impact model indicate that SCS therapy, although associated with initial higher costs, has the potential to result in cost savings from year three onwards.