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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 6/2014

Open Access 01-12-2014 | Review Article

The MAGEC System for Spinal Lengthening in Children with Scoliosis: A NICE Medical Technology Guidance

Authors: Michelle Jenks, Joyce Craig, Joanne Higgins, Iain Willits, Teresa Barata, Hannah Wood, Christine Kimpton, Andrew Sims

Published in: Applied Health Economics and Health Policy | Issue 6/2014

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Abstract

Scoliosis—structural lateral curvature of the spine—affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18).
Footnotes
1
The changes in the Cobb angle, total spine height and thoracic spine height were calculated from the random-effects model. The difference between final follow-up results and pre-operative results were used.
 
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Metadata
Title
The MAGEC System for Spinal Lengthening in Children with Scoliosis: A NICE Medical Technology Guidance
Authors
Michelle Jenks
Joyce Craig
Joanne Higgins
Iain Willits
Teresa Barata
Hannah Wood
Christine Kimpton
Andrew Sims
Publication date
01-12-2014
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 6/2014
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-014-0127-4

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