Opioid use following BKP/VP

Retrospective analysis summary

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Interventional treatments impact opioid use

A 7-month retrospective analysis compared opioid use and hospital visits for 8,845 VCF patients before and after a balloon kyphoplasty (BKP) or vertebroplasty (VP) procedure. Findings for these BKP/VP patients showed:

  • 48.7% stopped taking opioids entirely.1
  • 8.4% reduced their dose relative to pre-surgery levels.1
  • The average all-cause payer costs were reduced significantly (-$6,759).1
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Overview

A 7-month retrospective healthcare claims analysis using the Truven database, coauthored by physicians and Medtronic health economics employees, analyzed the impact of opioid prescription fills on medical visits, opioid usage, and prescription costs in patients with vertebral compression fracture (VCF).

Patient claims were followed from the second month to the seventh month after respective BKP or VP procedure discharge dates. 

Methods

  • The IBM Truven MarketScan™* research database (2008–2018) was used, which includes de‐identified information on >135 million patients with commercial insurance, including Medicare Advantage (MA), in the United States.
  • The study was co‐authored by physicians and Medtronic health economics employees.
  • Patients with VCF were identified with ICD-9 and ICD-10 diagnosis codes, and treatment with BKP or VP with ICD-10 and CPT procedure codes.
  • The primary endpoint was defined as change in opioid use in the 6 months before versus months 1–7 after BKP/VP treatment. The first month after surgery was excluded as a washout period to exclude prescriptions for immediate post‐operative pain (versus for ongoing pain related to the VCF).

 

57%

decreased or discontinued opioid use after 7 months follow-up among patients with any opioid use pre- and/or post-surgery.1


For patients who decreased or discontinued opioid use:

Average number of treated days in the 2 months prior to surgery was

22.1 days

versus 9.7 in the 2-month post-washout1

Average daily MME in
the 2 months prior to
surgery was

7.2 mg/day

decreased to zero in follow-up1

There were significantly reduced average all-cause payer costs after

7 months

in follow-up compared to baseline1

Limitations

  • This study is limited to patients with commercial insurance coverage (including MA) but does not represent the full Medicare population.
  • Pain and functional scores were not available in billing data.
  • Prescriptions filled do not necessarily equal prescriptions consumed; we could not track prescriptions for active pain management versus pro re nata.


Balloon kyphoplasty indication and risk statements

Kyphon™ Balloon Kyphoplasty is a minimally invasive procedure for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesion. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung cancer, or lymphoma. Benign lesions include hemangioma and giant cell tumor.

The overall complication rate with the procedure has been demonstrated to be low. Risks of acrylic bone cements include cement leakage, which may cause tissue damage, nerve or circulatory problems, and other serious adverse events, such as: cardiac arrest, cerebrovascular accident, myocardial infarction, pulmonary embolism, cardiac embolism.

For complete information regarding indications for use, contraindications, warnings, precautions, adverse events, and methods of use, please reference the devices’ Instructions for Use included with the product.

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kyphoplasty

BKP treatment uses balloons to restore vertebral height and bone cement for stabilization, helping reduce pain caused by VCFs.

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1

Ni W, Ricker C, Quinn M, Gasquet N, Janardhanan D, Gilligan CJ, Hirsch JA. Trends in opioid use following balloon kyphoplasty or vertebroplasty for the treatment of vertebral compression fractures. Osteoporos Int. 2021 doi: 10.1007/s00198-021-06163-3. Epub ahead of print. PMID: 34729624.