Wrist-Worn Neuromodulation Device Cost Effective for Essential Tremor
According to data from a retrospective analysis, the wrist-worn neuromodulation device (Cala Trio; Cala Health, Inc, Burlingame, CA) is a cost-saving treatment option for individuals with essential tremor (ET). The analysis demonstrates that ET is associated with substantial health care resource utilization (HCRU) and economic burden on affected individuals and the US healthcare system. There is a high prevalence of multiple comorbidities in individuals with ET that vary based on different approaches to therapy.
Results shown for retrospective cohort studies were conducted using administrative claims data from a US citizen paying for health care, specifically covering 5,286 individuals with ET. Patient demographics and comorbid conditions were reviewed with the use of the data found within 6 months before the index date. Amongst the 5,286 individuals with ET, 71.3% received some pharmacotherapy, 26% were untreated, and 2.7% had refractory surgery during the 12-month follow-up.
Results of 1 analysis demonstrate the annual cost of the neuromodulation device is comparable to high-dose, first-line pharmacotherapies, it offers lower costs compared with existing pharmacotherapies and surgical and nonreversible procedures when considering the cost of therapy, dosing, and side effects. There would be minimal budget impact when adopting the device into an individual’s healthcare plan. The device was concluded to be a fixed- and low-cost, on-demand therapy that is a safer and more effective.
The analysis had 5,286 participants with a mean age of 70.8 years, 49.1% were female, 17.1% had commercial insurance, and 82.9% had Medicare Advantage. Individuals with refractory surgery were younger (untreated 72.0 years, pharmacotherapy 70.5, surgery 67.2, P<.0001), more were female (untreated 45.6%, pharmacotherapy 49.7%, and surgery 69.7%, P<.0001), and had smaller overall comorbidity burden as assessed by age-adjusted Charlson Comorbidity Index (untreated 4.3, pharmacotherapy 4.4, and surgery 3.7, P=.0161). A majority of the had multiple comorbidities (overall 5.4, untreated 4.8, pharmacotherapy 5.5, and surgery 5.5, P<.0001). The most common psychiatric disorders before and after ET diagnosis were depression, anxiety and stress adjustment disorder, and substance abuse. The incidence of psychiatric disorders displayed differing consistencies based on age, diagnosis time, and type of treatment.
Of the 5,286 individuals, 95% had specialist visits, 41.8% had emergency visits, and 29.5% were admitted as inpatient. All-cause medical costs had an average of $12,962 per patient per year (PPPY), pharmacy costs were $3,892 PPPY, and total health care costs were $16,854 PPPY. The total of ET-related costs were $1,386 PPPY (8.1% of total healthcare cost). With the addition of ET-related treatment total health care costs significantly increased (untreated $12,900 PPPY, pharmacotherapy $17,916 PPPY, surgery $29,328 PPPY, P<.0001).