Table 3.
Unit costs for SNS.
| Expenditure type | Unit cost (£) |
Cost per patient (£) | References and assumptions |
|---|---|---|---|
| Device | |||
| Temporary SNS | |||
| Temporary SNS kit (includes 2 × 9 cm needles) | 210 | 210 | Medtronic 2013 (personal communication). Single use |
| 12.5 cm needles pack of 6 | 135 | 0.45 | Medtronic 2013 (personal communication). Single use, assumes two needles per patient, required for 1% of patients |
| Power source | 335 | 18.61 | Medtronic 2013 (personal communication). Multiple use, assumes 18 patients as per trial |
| Permanent SNS | |||
| Patient programmer | 500 | 500 | Medtronic 2013 (personal communication). Single use |
| Pulse generator | 5,700.00 | 5,700.00 | Medtronic 2013 (personal communication). Single use |
| Tined lead | 1,350.00 | 1,350.00 | Medtronic 2013 (personal communication). Single use |
| Lead introducer kit | 200 | 200 | Medtronic 2013 (personal communication). Single use |
| Procedures | |||
| Temporary SNS | |||
| Initial consultation | 123 | 123 | NHS reference costs.30 Consultant-led: first attendance nonadmitted face to face, colorectal surgery |
| Physiology testing: | |||
| Outpatient appointment | 99 | 99 | NHS reference costs.30 Nonconsultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Ultrasound | 51 | 51 | NHS reference costs.30 Diagnostic imaging: outpatient. ultrasound scan, less than 20 min |
| Fluoroscopy | 119 | 119 | NHS reference costs.30 Diagnostic imaging: outpatient. contrast fluoroscopy procedures, less than 20 min |
| Second consultation | 93 | 93 | NHS reference costs.30 Consultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Counseling | 99 | 99 | NHS reference costs.30 Nonconsultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Pre-assessment for operation | 99 | 99 | NHS reference costs.30 Nonconsultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Procedure | 599 | 599 | NHS reference costs.30 Intermediate pain procedure, day case |
| Postoperative medication: paracetamol 500 mg for 7 days | 2.88 | 2.88 | BNF 2014. Nonproprietary, 0.5–1 g every 4–6 h |
| Specialist nurse review | 99 | 99 | NHS reference costs.30 Nonconsultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Permanent SNS | |||
| Pre-assessment for operation | 99 | 99 | NHS reference costs.30 Nonconsultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Procedure | 4,268.00 | 4,268.00 | NHS reference costs.30 Insertion of neurostimulator or intrathecal drug delivery device, day case |
| Postoperative medication: | |||
| Co-codamol 8/500 mg for 14 days | 3.4 | 3.4 | BNF 2014. Nonproprietary, 100-tab pack, 1–2 tablets every 4–6 h |
| Co-amoxiclav 500/125 mg for 5 days | 3.03 | 3.03 | BNF 2014. Sandoz, 21-tab pack, 1 tablet every 12 h |
| Post-operation check at 6 weeks | 93 | 93 | NHS reference costs.30 Consultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Total cost temporary SNS | 1,612.94 | ||
| Total cost permanent SNS | 12,216.43 | ||
| Maintenance | |||
| Battery change: | |||
| Removal of device | 599 | 35.94 | NHS reference costs.30 Intermediate pain procedure, day case |
| Re-implantation | 4,268.00 | 256.08 | NHS reference costs.30 Insertion of neurostimulator or intrathecal drug delivery device, day case |
| New device | 7,750.00 | 465.00 | Cost of device for permanent SNS (see top of this table) |
| MRI scan: | |||
| Removal of device | 599 | 11.09 | NHS reference costs.30 Intermediate pain procedure, day case |
| Re-implantation | 4,268.00 | 79.04 | NHS reference costs.30 Insertion of neurostimulator or intrathecal drug delivery device, day case |
| New device | 7,750.00 | 143.52 | Cost of device for permanent SNS (see top of this table) |
| Consultation | 93 | 7.44 | NHS reference costs.30Consultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Postoperative medication: | |||
| Co-codamol 8/500 mg for 14 days | 3.4 | 0.27 | BNF 2014. Nonproprietary, 1–2 tablets every 4–6 h |
| Co-amoxiclav 500/125 mg for 5 days | 3.03 | 0.24 | BNF 2014. Sandoz, 1 tablet every 12 h |
| Post-operation check | 93 | 7.44 | NHS reference costs.30 Consultant-led: follow-up attendance nonadmitted face to face, colorectal surgery |
| Maintenance cost over 5 years | 1,004 |
MRI, magnetic resonance imaging; NHS, National Health Service; SNS, sacral nerve stimulation.