Pre-surgical functional mapping of the brain using the Nexstim NBS System (navigated transcranial magnetic stimulation, nTMS) allows more patients diagnosed with brain tumor to benefit from surgery and reduces patients’ length of stay. Adding an NBS brain mapping service allows healthcare providers to both improve a hospital’s DRG revenues, through increased surgery volumes, as well as reduce the associated costs.
It has been established that the use of functional diagnostics during surgery allows up to 30% of patients previously considered inoperable to be operated on (Duffau H et al. Contribution of intraoperative electrical stimulations in surgery of low grade gliomas: a comparative study between two series without (1985-96) and with (1996-2003) functional mapping in the same institution. Journal of Neurology, Neurosurgery, and Psychiatry Jun 2005, 76(6):845-851).
Studies further show that patients undergoing NBS brain mapping prior to surgery are discharged from inpatient care sooner. In a study comparing hospital length of stay for patients without nTMS mapping, who experienced an average in-hospital stay of 14 days, the stay in the nTMS group was reduced to 12 days when nTMS was used for presurgical mapping (p=0.0172) (Krieg S et al. Changing the clinical course of glioma patients by preoperative motor mapping with navigated transcranial magnetic brain stimulation. BMC Cancer (2015) 15:231).
Use of the NBS System for presurgical mapping helps lower the post-operative risks posed by brain surgery and can avoid the costs associated with tumor reoperation.
Using the NBS system prior to treatment decision-making can result in patients with inoperable tumors being more clearly identified prior to surgery, reducing the number of unnecessary invasive diagnostic procedures.
For patients with operable tumors, it has been shown that there is a significantly lower rate of residual tumor after surgery if patients first undergo pre-operative nTMS mapping. In a 2015 study, 34.3 % of patients in the NBS group had residual tumors compared to 54.3 % in a control group. (Krieg et al. 2015.)
Since re-operations are often needed for patients with residual tumors, avoiding such a follow-on procedure can save the payer up to € 10,000 per patient.
Furthermore, availability of NBS mapping data to the neurosurgical team can increase resection rates without increasing post-operative morbidity—for example, paresis or other neurological deficit. Post-surgical morbidity incurs additional costs to the payer for rehabilitation, physiotherapy, occupational therapy and the need for assistive devices. Avoiding the need for such post-operative care can save up to € 1,200 per patient, based on Germany’s therapeutic products directive (Heilmittel-Richtlinie).
NBS mapping is a modern technique for planning brain surgery. An NBS System complements the other modern facilities available at hospitals marketing state-of-the-art brain surgery services.
Interdisciplinary centers offering NBS mapping work closely with the outpatient sector for pre- and post-treatment care in order to be able to offer the most effective and least invasive treatment for the individual patient.
Please contact Nexstim here on reimbursement issues. Our team can assist you with:
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