Targeted drug delivery
Chronic pain
Patient selection and clinical evidence
Helping patients manage chronic pain with targeted drug delivery
Targeted drug delivery is effective in reducing or eliminating the need for systemic opioids when used to treat chronic pain.1
SynchroMed™ implantable infusion system
The SynchroMed™ III implantable infusion system delivers prescribed medication directly into the intrathecal space, thereby bypassing the blood-brain barrier. As a result, only a fraction of the oral dose is needed to produce efficacy while minimizing systemic side effects.2
Patient selection: targeted drug delivery for people with chronic intractable pain3
Patient selection for the treatment of chronic intractable pain requires a closer examination of criteria. In most cases, a psychological evaluation is indicated to examine factors such as patient expectations, psychosomatic components of the pain, and secondary gain motivation.
Selection guidelines for patients include:
- Patient experiences inadequate pain relief and/or intolerable side effects from systemic opioid therapy
- Patient has objective evidence of pathology
- Patient obtains psychological clearance
- Patient has no untreated substance abuse
- Patient has sufficient body size to accept the bulk and weight of the pump
- Clear therapy goals and realistic expectations have been established
- No contraindications to surgery or the therapy exist
- Patient has a favorable response to the screening test
Clinical outcomes
Studies confirm efficacy of targeted drug delivery
Pain relief
- Significant improvement in back and leg pain at 6 and 12 months (p < 0.001) compared to baseline5
- 60% mean pain relief after 6 months4
Improved function and quality of life
- 87% of patients rated their quality of life as fair to excellent5
- 74% of patients reported increased activity levels4
- 66% of patients successfully reduced their disability at 12 months5
Patient satisfaction and reduction in oral medication
- 88% of patients were satisfied with intrathecal therapy4
- After one year of TDD 43% of patients completely discontinued systemic opioid medication use. Among those continuing systemic medication, the average daily dose decreased in 75% of patients.1
- 90% of patients would recommend therapy to a family member or friend5
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Cost-effective versus conventional treatments
- Evidence suggests that the 3 to 5 year costs of TDD may be less compared to conventional medical management (CMM).6,7 Savings were driven by lower inpatient costs and prescription drug costs.6
- Once study projecting to lifetime cost estimated a savings of $3,111 per patient per year when treated with TDD compared to CMM.6
- A cost-effectiveness model showed that for the majority of model scenarios TDD was cost-effective relative to conservative medical management over a 10-year time period.8