iFuse implant system could save Medicare US$660 million


A report in ClinicoEconomics and Outcomes Research indicates that the lifetime costs of treating appropriately selected Medicare patients with minimally invasive sacroiliac joint fusion (iFuse, SI-Bone) could result in savings from US $660 million to US $4 billion when compared with lifetime costs of non-operative care. The report authors developed an economic model to simulate the lifetime costs of treating Medicare patients with minimally invasive sacroiliac joint fusion in the hospital inpatient setting and compared it to the costs of treating similar patients with non-operative care.

According to a SI-Bone press release, the analysis in the report included patients with a limited number of diagnosis codes to conservatively estimate the total population of patients with sacroiliac joint disorders. Based on this analysis, 196,452 Medicare beneficiaries had a sacroiliac joint diagnosis resulting in an estimated lifetime cost for non-operative care of US $51,543 per patient compared to an estimated lifetime cost of US $48,185 per patient for minimally invasive sacroiliac joint fusion.

The authors performed sensitivity analyses on a number of input variables to assess the robustness of the model.  One of those variables was the addition of a more general diagnosis code for low back disorders that ensured inclusion of additional patients with sacroiliac joint pain. However, that diagnosis code also includes patients with other back disorders. When this code was included in the analysis, the number of Medicare beneficiaries with possible sacroiliac joint pain increased to 478,764 patients, with a per patient lifetime cost savings of US $8,692 according to the model.  This resulted in a potential cost savings to Medicare of US $4.16 billion if minimally invasive sacroiliac joint fusion is performed instead of non-operative care in all these patients.

David Polly, a co-author of this study comments:  “My belief is that sacroiliac joint disorders represent a significant physical and financial burden to the US population. This paper is a rigorous investigation that, if the parameter estimates are correct, shows minimally invasive sacroiliac joint fusion is cost saving”