Clinical and cost-effectiveness analysis of an open label, single-centre, randomised trial of spinal cord stimulation (SCS) versus percutaneous myocardial laser revascularisation (PMR) in patients with refractory angina pectoris: The SPiRiT trial

Abstract

Background: Patients with refractory angina have significant morbidity. This study aimed to compare two of the treatment options, Spinal Cord Stimulation (SCS) and Percutaneous Myocardial Laser Revascularisation (PMR) in terms of clinical outcomes and cost-effectiveness.

Cost-Effectiveness of Spinal Cord Stimulation Therapy in Management of Chronic Pain

“…A cost‐effectiveness analysis of the SCS vs percutaneous myocardial laser revascularization (PMR) in patients with RAP (SPiRiT) RCT failed to establish a favorable cost‐effectiveness profile for SCS at 24 months follow‐up . Interestingly, significant changes in ICER were observed over time, which the authors attribute to a learning curve effect.…”

Evaluation of the long‐term cost‐effectiveness of liraglutide vs lixisenatide for treatment of type 2 diabetes mellitus in the UK setting

“…Annual treatment costs in each arm captured GLP‐1 receptor agonist therapy (liraglutide 1.8 mg or lixisenatide 20 µg), concomitant metformin, needles for injection of GLP‐1 receptor agonists, and self‐monitoring of blood glucose testing (assumed to be 3 tests per week in both arms). Costs of treating diabetes‐related complications were identified through literature review, with costs inflated to 2015 values using the Hospital and Community Health Services price index where necessary . To capture the impact of diabetes‐related complications on quality of life, utilities were applied in the year of the complication and in subsequent years.…”

Therapy for Angina Pectoris Secondary to Coronary Disease

“…Published evidence supports SCS as effective and acceptably safe for patients with refractory angina who are unresponsive to medical and surgical intervention (Bondesson et al, 2008;de Vries et al, 2007;Diedrichs et al, 2005;Dyer et al, 2008;Eddicks et al, 2007;Lapenna et al, 2006;McNab et al, 2006). Recently, a meta-analysis of 7 randomized controlled trials involving 270 patients (Taylor et al, 2009) found benefits similar to those of CABG and percutaneous myocardial laser revascularization (PMR).…”