To compare the analgesic effects and total medical cost of intrathecal drug delivery system (IDD) with conventional analgesics therapy (CAT) for intractable pain in advanced cancer patients.

Thirty-six patients with advanced cancer pain, male 19 cases, female 17 cases, aged 30-79 years old, in department of Pain Management of Weihai Municipal Hospital from December 2013 to December 2016 were treated with implantable intrathecal drug delivery port system. Patients were divided into three groups according to the median morphine-equivalent oral dose (conversion dose, 240 mg) per day before intrathecal treatment. The oral morphine dose was less than the median dose or equal as the median dose in the low-dose group (n=19), while the dose was more than the median dose in the high-dose group (n=17). The implanting procedure was same in all patients. NRS at rest were recorded at 1 d before the operation, and at 2nd day, 4th day, 7th day, 14th day, 28th day after the operation, as well as at the last observation before patients passed away. The data of intrathecal drugs and infusion pump were recorded after intrathecal treatment. The cost of pain management by all means was recorded at 4 and 8 weeks for each patient after the intrathecal treatment.

NRS was significantly lower at each time point after the intrathecal treatment than that before the operation (all P<0.05). In low-dose group, the cost was significantly higher in 4 and 8 weeks than the estimated cost of CAT (allP<0.05). In high-dose group, the cost was more than the estimated cost of IDD in 4 weeks, but there was no significant difference between them (all P>0.05), while the cost was significantly lower in 8 weeks than the estimated cost of CAT (P<0.05). In the whole group, the cost was significantly higher in 4 weeks than the estimated cost of CAT (P<0.05), but there was no significant difference in the cost of the two methods in 8 weeks (P>0.05).

For advanced cancer patients with large demand for analgesic drugs and with a relatively long life expectancy, the intrathecal drug delivery system can not only provide better analgesic effect, but also require lower economic cost than conventional analgesics therapy.

Pain, intractable; Neoplasms; Infusion pumps, implantable; Injection, spinal; Analgesia; Cost-benefit analysis