OBJECTIVES: Postdural puncture headache (PDPH) is one of the most common complications of diagnostic, therapeutic, or inadvertent lumbar punctures. Compared to conventional cutting or beveled spinal needles, pencil point spinal needles have been conclusively proven to reduce the incidence of PDPH, but their potential economic benefit is not well-known. A customizable cost calculator was created to assess the impact of adopting pencil point spinal (atraumatic) needles over conventional cutting (traumatic) needles.

METHODS: A decision-analytic model was developed using MS Excel based on the framework published by Tung et al. to estimate the impact of atraumatic needles versus traumatic needles on the incidence of PDPH as well as associated healthcare resource utilization and costs. The number and cost of PDPH cases, and utilization and costs of traumatic needles, atraumatic needles, and general anesthesia (post needle insertion failure), were considered from a single payer-provider perspective for Mexico.

RESULTS: The base-case model assumed 1,000 spinal anesthesia procedures annually, with an increase in utilization of atraumatic needles from 10% to 70%. As per published references of clinical and economic inputs, 16 fewer cases of PDPH and 11 fewer procedures of general anesthesia were estimated. Considering the calculated 502 fewer traumatic needles and 600 additional atraumatic needles, the incremental cost of device mix was 22,134 MXN. Estimated cost savings were 23,592 MXN in general anesthesia and 71,543 MXN in PDPH management. Thus, the overall potential change in utilization was associated with a reduction of 73,001 MXN in total cost.

CONCLUSIONS: The higher adoption of pencil point needles may be associated with positive clinical and economic impact by potentially reducing the incidence of PDPH and the burden of its management. The use of the pencil point needle, despite its higher upfront investment, could lead to improved healthcare utilization based on its economic value story.