TENS System for Low Back Pain Could Save CMS Millions

Medicare could save millions of dollars with an $880 million investment to supply a transcutaneous electrical nerve stimulation (TENS) system to patients with chronic low back pain, according to results of a recently presented study.

“We found that [transcutaneous electrical nerve stimulation system] TENS in [chronic low back pain] CLBP reduces the need for medical resource utilization specifically around the elements of interest and also of payment in the CLBP space,” Michael E. Minshall, M.P.H., said. “We excluded the economic benefits of chronic opioid addiction because patients who don’t use TENS had more incidents of that, and then TENS also excluded any kind of reduced back pain for employee productivity.”

Minshall said that the study results indicate the Centers for Medicare &Medicaid Services could save an estimated $417 million in treatment costs alone if the investment is made. The financial impact calculation in the impact statement estimated that using current standard of care procedures to treat approximately 1.5 million Medicare beneficiaries who have CLBP and seek medical interventions now costs approximately $1.3 billion.

The figures are based partly on a study that looked at the clinical and economic impact of TENS in patients with CLBP. The study evaluated patients who were given TENS for one year prior to intervention and for one year of follow-up compared with a statistically matched group without TENS. Patients treated with TENS had significantly fewer hospital and clinic visits, used less diagnostic imaging, had fewer physical therapy visits, and required less back surgery than patients receiving other treatment modalities, according to study results.

“What I tried to do was apply our study results to the Medicare population completely hypothetically and what the impact often in CLBP can be with Medicare, and when you multiply out all the reduction in resources and put that in the credit column, and if you hypothetically put TENS in all Medicare patients –– and by the way Medicare patients with CLBP we estimated to be 1.5 million of the total 50 million Medicare enrollees –– you could save almost a half a billion dollars just in the cost offsets for the resource use,” Minshall said.