Australian healthcare professionals are advocating for a re-evaluation of spinal cord stimulators following research indicating that one in four patients require revision surgery due to complications. These devices, commonly employed for managing chronic pain conditions such as back, neck, and nerve pain, consist of a battery pack implanted under the skin, linked to electrodes delivering electric pulses aimed at disrupting pain signals from the nervous system.
A recent study, published in the Medical Journal of Australia by prominent doctors, revealed that 23% of patients fitted with spinal cord stimulators experience complications necessitating additional surgery within three years. The median cost for these permanent devices is approximately AUD 56,000, with some patient expenses exceeding AUD 500,000.
The researchers argue that the limited evidence supporting the efficacy of spinal cord stimulators, combined with a concerning risk profile, warrants a reassessment of their use for pain management. Dr Caitlin Jones, the study’s lead author from the University of Sydney, cautioned that patients should be aware of the significant financial and health risks associated with these devices, which have a low likelihood of providing benefit.
Supporting this viewpoint, Private Healthcare Australia (PHA), which represents health insurance funds, has endorsed calls for reconsidering the application of spinal cord stimulators. PHA CEO Dr Rachel David noted that while some stimulators have been deregistered by the Therapeutic Goods Administration (TGA) and restrictions placed on others, they remain accessible for patient use. She argued that if these stimulators were to undergo evaluation for Medicare funding today, they would likely be classified as too hazardous.
Dr David urged the Australian Government to request an assessment from the Medicare Services Advisory Committee to determine if these devices meet current safety and efficacy standards, and to remove them from the Medicare listing if they fall short. This action would help protect patients from unnecessary risks and prevent wastage of taxpayer funds.
Currently, it is estimated that 90% of spinal cord stimulators are inserted within the private healthcare sector. Dr David expressed a commitment among health funds to continue offering evidence-based treatments that have proven safe and effective for chronic pain management.
In contrast, the Medical Technology Association of Australia (MTAA), representing device manufacturers, maintains that spinal cord stimulators are safe and effective. They assert that these devices serve as a viable alternative to long-term opioid use, emphasising their reliability based on extensive clinical trial and real-world evidence.