Table 22:
SCS Device Costs
| Overall Cost, $a | Source | |||
|---|---|---|---|---|
| Devices Currently Available in Ontariob | ||||
| Rechargeable tonic wave, Boston Scientific Inc. | 27,000.00c | Boston Scientific Inc. (average based on provided list prices, January 2019) | ||
| Rechargeable tonic wave, Medtronic Inc. | 19,995.00c | Medtronic Inc. (average based on provided list prices, January 2019) | ||
| Burst wave systems, Abbott | 29,300.00d | Estimate (written communication, Aaron Hong, MD, November 2018) | ||
| Overall estimated average cost | 24,464.58e | Crude estimate accounting for variability in practice | ||
| Device Newly Available in Ontario (Next 5 Years; i.e., Freedom 8A) | ||||
| Freedom 8A (3 modalities: tonic, burst, and 10-kHz high-frequency) | 22,350.00f | Stimwave Technologies Ltd. (estimated from list price; written communication, November 2018) | ||
| Device Not Available in Ontario | ||||
| Senza HF10 SCS system | 207,066.86g,h | Estimate (written communication, MOH OOC-PA, June 2018) | ||
Abbreviations: MOH, Ontario Ministry of Health; OOC-PA, Out-of-Country Prior Approval program; SCS, spinal cord stimulation.
All costs are reported in 2018 Canadian dollars.
See Table 18 for the specific trade names of SCS systems used in Ontario; the list prices are proprietary and are not shown in this table. We have estimated an average device cost by manufacturer, and have used those costs to estimate an overall average for SCS devices available in Ontario.
Information received from the manufacturers (oral and written communications, Boston Scientific Inc., Medtronic Inc., November 2018 through January 2019). The prices of an average rechargeable SCS device (by Boston Scientific Inc.) include the IPG, the implantable leads typically used with these systems, surgical anchors and other surgical tools that are often used during the procedure, and patient accessories like remote controls, or chargers, if applicable (written communication, Boston Scientific Inc., January 2019).
Information received during expert consultation (oral and written communications, Aaron Hong, MD, November 2018 through January 2019).
A crude average estimate of the cost of a SCS device was computed as follows: [($27,000 × 0.5 + $19,995 ×0.5) × 5 + (1 × $29,300)]/6 = $24,464.58.
The cost of the Freedom SCS system was based on list price estimates provided for Freedom 8A; it represents an actual cost of the technology and not the cost of future innovations; the cost includes the following cost components: device including 2 stimulators and system bundle, SandShark injectable anchor system, replacement charger, touchy needle 6“ (14 gauge), guidewire 3 pack, waist belt and peripheral band (written communication, Stimwave Technologies Ltd., November 2018).
The outsourcing treatment for the Senza HF10 SCS system was estimated at US$154,000 (2018 dollars; written communication, Out-of-Country Prior Approval program, Ontario Ministry of Health, June 2018).
Considered in a scenario analysis.