PAIN MANAGEMENT 2025, VOL. 15, NO. 1, 27–36 https://doi.org/10.1080/17581869.2025.2449810

RAPID COMMUNICATION

Real-world healthcare utilization and costs of peripheral nerve stimulation with a micro-IPG system

Hemant Kalia a , Bishnu Thapa b , Peter Staats c , Patrick Martin d , Kori Stetter b , Becca Feldman b

and Carl Marci e

a Center for Research & Innovation in Spine and Pain, Rochester, NY, USA; b Epidemiology Department, OM1, Inc., Boston, MA, USA; c National Spine & Pain Centers, Freehold, NJ, USA; d Clinical Affairs, Nalu Medical, Inc., Carlsbad, CA, USA; e Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

ABSTRACT ARTICLE HISTORY Aim: To characterize real-world healthcare resource utilization (HCRU) and costs in adults with chronic pain of peripheral origin treated with peripheral nerve stimulation (PNS) using the micro-implantable pulse generator (IPG). Materials & Methods: This retrospective observational study (9/1/19–1/31/23) linked patients from the Administrative claims; Nalu medical database to the OM1 Real-World Data Cloud (RWDC). Eligible patients received the micro-IPG implant for PNS, were identifiable in both databases, and had ≥ 12 months of pre/post- implantation claims data. Primary outcomes were all-cause HRCU and medical costs (12 months pre- and post-implantation); secondary outcomes were all-cause pharmacy costs, including opioids, over the same timeframe.

Results: Patients (N = 122) had a higher mean (standard deviation; SD) number of outpatient visits pre-implantation (5.7 [5.4]) than post-implantation (4.9 [5.7]). Mean (SD) total medical costs were 50% lower, from $27,493 ($44,756) to $13,717 ($23,278). Median (first-third quartile [Q1-Q3]) medical costs were 57% lower, from $11,809 ($4,075–$31,788) to $5,094 ($1,815-$13,820). Mean (SD) pharmacy costs (n = 77) were higher post-implantation ($22,470 [$77,203]) than pre-implantation ($20,092 [$64,132]), while median (Q1-Q3) costs were lower (from $2,708 [$222 -11,882] to $2,122 [$50–9,370]). Post-implantation, the proportion of patients using opioids was 31.4% lower.

Conclusion: Patients with PNS using the micro-IPG had reduced HCRU, costs, and opioid use.

PLAIN LANGUAGE SUMMARY Title: Healthcare Use and Costs with a Peripheral Nerve Stimulation Device for Chronic Pain Summary: This study reviewed the medical records of 122 adults who received peripheral nerve stimulation (PNS), a treatment for chronic pain, to understand how PNS affects patient healthcare use and costs. Healthcare use and costs in the year before PNS were compared with the year after. The results showed that PNS helped reduce the number of doctor’s visits and medical expenses. After starting PNS therapy, the average number of outpatient doctor’s visits was lowered from 5.7 to 4.9 per year, and total medical costs were cut in half, from $27,493 to $13,717. In addition, the number of patients using opioids went down by 31.4%.

1. Introduction

Chronic pain is persistent or recurring pain lasting ≥3 months. According to the US CDC, 52 million people (approximately 1 in 5 US adults) have chronic pain. Peripheral nerve pain is a particularly severe manifestation of chronic pain resulting from disease or nerve injury, estimated to affect one-third of US chronic pain patients. Despite guidelines indicating that initial therapy should prioritize non-pharmacologic care, the pharmacotherapeutic management of chronic pain often involves opioid and non-opioid medications. Research confirms that chronic pain substantially impairs quality of life (QoL) and is associated with lost productivity.

2. Materials & Methods

2.1. Study design, objectives, and data source

This retrospective observational cohort study of patients who received the micro-IPG for PNS was conducted on patients with relevant data between 1 September 2019 and 31 January 2023. The primary outcome objectives were to describe the baseline demographic and clinical characteristics of patients, characterize all-cause HRCU, and estimate the cost of all-cause medical care in the 12 months prior to and following micro-IPG implantation.

2.2. Study population

Patients had to be ≥18 years of age, identifiable in both the manufacturer’s database and OM1 RWDC, implanted for PNS during the study identification period, and have ≥12 months of medical claims data in the OM1 RWDC prior to and following the index date. Patients were excluded if they had a diagnosis of stroke, myocardial infarction, or cancer during the study period.

3. Results

3.1 Healthcare resource utilization

Mean (SD) number of outpatient visits pre-implantation was higher (5.7 [5.4]) than post-implantation (4.9 [5.7]).

3.2 Healthcare costs

Mean (SD) total medical costs lowered by 50%, from $27,493 ($44,756) prior to implantation to $13,717 ($23,278) after implantation.

3.3 Pharmacy costs and opioid use

Pharmacy costs (n=77) showed in mean (SD) $20,092(64,132) pre-implantation and $22,470(77,203) post-implantation.

6. Conclusions

This study provides evidence evaluating healthcare costs and resource utilization with PNS. In the 12 months following PNS device implantation, patients treated with the micro-IPG had reduced HCRU, healthcare costs, and opioid use compared to conventional treatment alone. This research supports the use of the micro-IPG for PNS in patients with chronic pain of peripheral nerve origin.