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iFuse Implant System for Treating Chronic Sacroiliac Joint Pain: A NICE Medical Technology Guidance


  • Megan Dale

    (Cardiff & Vale University Health Board)

  • James Evans

    (Cardiff University)

  • Kimberley Carter

    (National Institute for Health and Care Excellence)

  • Susan O’Connell

    (Cardiff & Vale University Health Board)

  • Helen Morgan

    (Cardiff University)

  • Grace Carolan-Rees

    (Cardiff & Vale University Health Board)


Treatment and management of sacroiliac joint pain is often non-surgical, involving packages of care that can include analgesics, physiotherapy, corticosteroid injections and radiofrequency ablation. Surgical intervention is considered when patients no longer respond to conservative management. The iFuse Implant System is placed across the sacroiliac joint using minimally invasive surgery, stabilising the joint and correcting any misalignment or weakness that can cause chronic pain. The iFuse system was evaluated in 2018 by the UK National Institute for Health and Care Excellence (NICE) as part of the Medical Technologies Evaluation Programme (MTEP). Clinical evidence for iFuse suggests improved pain, Oswestry disability index (ODI) and quality of life compared to non-surgical management. The company (SI-Bone®) submitted two cost models indicating that iFuse was cost saving compared with open surgery and non-surgical management. Clinicians advised that non-surgical management was the most appropriate comparator and Cedar (a health technology research centre) made changes to the model to test the impact of higher acquisition and procedure costs. Cedar found iFuse to be cost incurring by approximately £560 per patient at 7 years. During the consultation period, the company reduced the cost of some iFuse consumables, and Cedar extended the time horizon to test the assumption that iFuse would become cost saving over time. These changes indicated that iFuse becomes cost saving at 8 years (approximately £129 per patient), after which the cost saving continues to increase. NICE published guidance in October 2018 recommending that the case for adoption of the iFuse system in the UK National Health Service (NHS) was supported by the evidence.

Suggested Citation

  • Megan Dale & James Evans & Kimberley Carter & Susan O’Connell & Helen Morgan & Grace Carolan-Rees, 2020. "iFuse Implant System for Treating Chronic Sacroiliac Joint Pain: A NICE Medical Technology Guidance," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 363-373, June.
  • Handle: RePEc:spr:aphecp:v:18:y:2020:i:3:d:10.1007_s40258-019-00539-7
    DOI: 10.1007/s40258-019-00539-7

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 1st June 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-06-01 11:00:00

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