- Restricting access to spinal cord stimulators can not only promote opioid addiction, but also exclude thousands of patients from professional and social life, says Professor Tomasz Mandat, head of the Nervous System Tumor Clinic at the National Cancer Institute.
Spinal cord stimulators (SCS) - a chance to live without pain and exclusion
Published May 29, 2025 09:00
Medexpress: What might be the long-term consequences of limiting the availability of spinal cord stimulators for Polish patients suffering from chronic pain?
Prof. Tomasz Mandat: On the one hand, the problem may be that more patients will become addicted to opioids. Thus, we may face a situation in Poland similar to the one currently facing the United States, where - according to forecasts - in 2025 about 100,000 people will die due to fentanyl addiction. On the other hand - more people will be diverted to pensions, as they will not be able to return to professional activity. There is also the problem of social isolation - patients will cease to be active in this field as well.
Chronic pain affects up to 20 percent of the general population. The situation is particularly difficult for oncology patients. Already at the time of cancer diagnosis, one in five patients suffers from chronic pain, and after five years of treatment this percentage rises to 50 percent - that is, one in two people experience chronic pain after cancer therapy. In the past, in the context of cancer, we used to expect life to be prolonged by one, two, maybe three years. Today - fortunately - we are increasingly faced with a situation in which cancer becomes a chronic disease. Patients are living longer, but also suffering longer. We can't offer them only opioid therapies, because they often exclude them socially. That's why we should develop and make available neuromodulatory therapies - they offer a chance for a better life without exclusion.
Medexpress: Have you calculated what the economic costs of such a reduction in the availability of pacemakers might be?
Prof. Tomasz Mandat: The cost-effectiveness of these therapies was confirmed many years ago. When comparing neuromodulation therapy with optimal drug treatment, it turns out that despite the high initial cost of implantation, after three years these costs equalize. In the analyses that were conducted, one very important factor was not taken into account - the return of patients to work. Once this aspect is taken into account, there is no doubt about the cost-effectiveness of such therapy - including from the perspective of the state.
