SCS Implant Volumes in Academic Centres

[Rocuronium18]

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I’m curious what the annual SCS implant (and explant) volumes are like in US academic centers.

I’m Canadian, and all of the SCS implanters in Canada are affiliated with universities/academic hospitals. We are rigorous with our pre-trial assessment, with mandatory psychology assessment, pain education, and longitudinal patient-reported outcome measurements. Our center does approximately 55-60 new implants per year, with ~2-3 explants per year for a variety of reasons (infection, old system MRI incompatibility, but also including loss of efficacy.)

Not that this should matter, nor is it relevant whatsoever to our decision-making, but we constantly hear things from the device companies about how small the Canadian market is relative to the US. I question this, because it is definitely an apples-to-oranges comparison, with regards to funding models, healthcare delivery, private versus public systems, and academic rigour in assessment of patients. I hear stories about how people are walking around with stimulators, regardless if they are effective or not, solely driven by profit for the centers implanting.

I’m curious what the volumes are like at academic centers, because I am assuming that they have similar pre-trial assessments and outcome measurements.

Thoughts/comments?

 

[Orin]

I'd warn you that in the US, academic centers aren't generally where the volume is. The overall market is always going to be bigger in the US, but let me give you a citation to look at for a volume reference.

Annual Number of Spinal Cord Stimulation Procedures Performed in the State of Florida During 2018: Implications for Establishing Neuromodulation Centers of Excellence

To assess the volume of spinal cord stimulation procedures performed by physicians in the state of Florida in 2018.

www.neuromodulationjournal.org

This for the entire state of Florida for a year, but you'll see that most physicians are doing less than 12 implants a year. If you have one implanter doing 50-60, that's a great center. If you've got a center doing 50-60 with 5 physician's, maybe they are less less skilled on average.