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Patients with an overactive bladder could have a rechargeable wireless device fitted to ease their condition, according to draft guidance from the National Institute for Health and Care Excellence.
NICE noted in its draft guideline document that around 19% of people in the UK had an overactive bladder, women and older patients most likely to be affected.
“This device will last longer than the current non-rechargeable system, resulting in a cost saving for the NHS”
Inserted under the skin in the upper buttock, the Axonics sacral neuromodulation (SNM) simulates the sacral nerve with an electric current via an electrode – a thin wire.
The electrode is attached to an implantable pulse generator which stimulates the nerves associated with bladder function.
The aim of the stimulation is to make the bladder work in a more controllable way – a bit like a pacemaker for the heart – noted NICE.
A handheld remote control operated by the patient activates the stimulator, adjusts the stimulation amplitude, and checks the battery status.
A wireless charger, attachable to the skin over the implanted stimulator is used to charge the stimulator.
According to Axonics, the battery needs a recharge every one-to-two weeks, for 30 minutes to one hour.
The implanted device, which costs £9,660, is programmed by a clinician in an outpatient setting using a portable tablet.
NICE said the Axonics device would be an option for people with symptoms of overactive bladder who have not responded to conservative treatments or drug therapy, in line with its guidelines.
Based on current data, NICE said it was thought the battery would last for around six years before it needed replacing, although there was some evidence to suggest it could last as long as 15 years.
Cost modelling by NICE suggested that six years was the point at which the device becomes cost saving compared with the current non-rechargeable system.
“This revolutionary device offers a new solution to help people managing this condition to go about their everyday lives free from worry”
Axonics SNS has potential to save the NHS around £6,200 per patient assuming a 15-year life span.
Meindert Boysen, director of the centre for health technology evaluation at NICE, said: “Clinical trial evidence seen by our independent committee shows that Axonics can help improve quality of life.
“This device will last longer than the current non-rechargeable system, resulting in a cost saving for the NHS after six years of use, and, importantly for patients, fewer replacement surgeries.”
Government health minister Nicola Blackwood said: “This revolutionary device offers a new solution to help people managing this condition to go about their everyday lives free from worry or disruption. Our priority is to ensure NHS patients have access to the latest innovative treatments.”
A consultation on the draft medical technology guidance is open to stakeholders until 13 March 2020.