KMID : 0363120170300040272
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Korean Journal of Pain 2017 Volume.30 No. 4 p.272 ~ p.280
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Retrospective analysis of the financial break-even point for intrathecal morphine pump use in Korea
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Kim Eun-Kyoung
Shin Ji-Yeon Castaneda Anyela Marcela Lee Seung-Jae Yoon Hyun-Kyu Kim Yong-Chul Moon Jee-Youn
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Abstract
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Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients¡¯ satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement.
Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients¡¯ satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient¡¯s actual medical costs and insurance information.
Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P £¼ 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P £¼ 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy.
Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.
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KEYWORD
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Chronic pain, Cost, Drug dosage calculation, Health insurance, Intrathecal morphine pump, Morphine, Patient satisfaction
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