Efficacy, not cost, similar for two nerve stim types

Percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) are safe and efficacious for the treatment of overactive bladder, although the former is much more cost effective, results of a recent study indicate.

The study, which was published in the Journal of Urology (2012; 189:210-6), compared PTNS delivered via the Urgent PC Neuromodulation System (Uroplasty, Minnetonka, MN) versus SNS (InterStim, Medtronic, Minneapolis). A Markov model was constructed to simulate the total costs and effectiveness of the modalities during 2 years. Cost data used average Medicare national physician payments and ambulatory payment classification and diagnosis-related group payments for hospital-based care and office visits. Clinical effectiveness and the rates of patient adherence to treatment and adverse events were estimated by a review of the literature.

The initial cost of PTNS therapy was $1,773 for 12 weekly treatments compared to $1,857 for the SNS test stimulation, according to the authors, led by Melissa Martinson, PhD, of Technomics Research, a Minneapolis-based consulting service. Over 2 years, the cumulative discounted costs for PTNS therapy were estimated to be $3,850 compared to the SNS implant at $14,160. Under a wide variety of conditions, PTNS remained significantly less costly than SNS over 2 years of therapy for those patients with OAB refractory to conservative and drug therapy, the authors reported.

"This study demonstrates significant cost savings to the health care system when PTNS is used instead of SNS. In our current U.S. health care climate, maintaining the quality of care while also controlling costs is a central objective. We believe that studies like this can contribute to attaining that goal," Dr. Martinson said.

Dr. Martinson and her co-authors have a financial interest and/or other relationship with Urolplasty. One of her co-authors has a financial interest and/or other relationship with Allergan, Astellas, Pfizer, and Watson.