By: Serdar Kiykioglu, CTO
Lone Star Neuromodulation, Inc.
A quick glance at the National Coverage Determination (NCD) for Electrical Nerve Stimulators reveals alarming guidelines that explain what is behind the prescription-opioid epidemic in this country.
Unbelievably, the guidelines discourage payments for the implantation of dorsal-column or deep-brain stimulators or services and supplies related to such implantation unless the implantation of the stimulator is used only as the late resort (if not the last resort) for patients with chronic, intractable pain.
Opioids are the first choice!
The same guidelines promote other treatment modalities, including pharmacological and surgical, as the primary options! Further, the guidelines state that the patients are to go through screenings, evaluation and diagnosis (including psychological as well as physical) by a multi-disciplinary team before a decision can be made.
The precious 2 years:
It has been shown that the long-term success rate of electrical-stimulation therapy modalities can reach 85% if they are used within 2 years of symptom onset. However, the current medical system prefers other options such as opioids despite all the risks, resulting in loss of precious time and recklessly exposing patients to the horrible effects of opioids including addiction, overdose and possible death!
Hiding behind the government guidelines...
It is convenient for insurance companies to save cost and improve profitability. It is unconscionable, however, to see that a pharmacological solution is being considered as a lower-cost option, while human lives are at stake.
The root cause of the issue
Government guidelines are at fault for not making the electrical-stimulation therapies as the primary option and insurance companies value their profitability over saving human lives. But what is the real issue?
To date, the cost of electrical stimulators and the required procedures are too high (~$30K) to make them affordable. Hospitals lose money on these procedures, and the majority of patients cannot afford the required deductible or the difference in the actual cost versus the amount that insurance will pay, even if they were approved to receive an electrical stimulator.
It does not have to be this way!
It is possible to design and mass produce low-cost electrical stimulators. Thanks to recent advancements in electronic technologies, an electrical stimulator and external devices can be designed and built using off-the-shelf parts, and the cost can be reduced to that of a mere fraction of traditional devices.
Insurance companies are businesses and, as such, they have every right to make a profit. However, when that profit comes at the cost of human lives, it's time to find a better way!
AUTHOR INFORMATION: Serdar Kiykioglu is one of the co-founders of Lone Star Neuromodulation, Inc., serving as its CTO since early 2014.