PMD7 Budget Impact Analysis of Transcutaneous Afferent Patterned Stimulation Therapy for the Treatment of Essential Tremor in the United States

Abstract

INTRODUCTION: Essential tremor (ET) is a chronic, progressive, and disabling neurological disease, managed with poorly tolerated, partially effective pharmacological treatments and, in some patients, costly surgical or non-reversible ablative procedures. Transcutaneous afferent patterned stimulation (TAPS), delivered by a novel personalized medical device, provides non-invasive, on-demand stimulation of the same key brain networks as the most effective surgery, deep brain stimulation, and has an extensive clinical program demonstrating its efficacy and safety in the treatment of ET. With TAPS device costs concentrated at treatment initiation, an economic analysis was conducted to assess the near-term budget impact of its introduction for the treatment of ET. A cost minimization model was developed to calculate the 3-year impact of introducing TAPS therapy for a healthcare plan cohort of 1,000,000 people. Prevalence of ET, as well as costs and incidence of surgical and non-reversible ablative procedures, were gathered from published literature. Acquisition costs and proportion of patients receiving pharmacological treatment options were sourced from Redbook and 24-month data from Truven databases. The economic impact of introducing TAPS was calculated based on an alternative scenario where 3% of patients from each treatment received TAPS therapy. Within the plan population, 2,992 patients were estimated to receive ET treatment. Introduction of TAPS therapy would have a 3-year budget impact of $62,126 (+0.25% compared with current costs; +$130,233 in the first year and approximately -$34,050 in subsequent years), or $20.56 per treated patient and $0.002 PMPM. Introduction of TAPS therapy for the treatment of ET had a modest budget impact in the near-term based on acquisition costs alone. TAPS therapy offers an additional, clinically meaningful option for the treatment of ET that is likely to be cost neutral or cost saving when pharmacological adverse event costs or surgical and procedure complication costs are considered.