Dáil Éireann - Volume 514 - 10 February, 2000

Written Answers. - Medical Treatment.

89. Mr. R. Bruton asked the Minister for Health and Children if his attention has been drawn to the benefits in pain management of spinal cord implants compared to high levels of drug therapy; if his attention has further been drawn to the fact that the VHI does not provide insurance cover for this and BUPA does; and if he will review the evidence on the effectiveness of this treatment in consultation with the VHI to examine if there are grounds for excluding cover. [3798/00]

Minister for Health and Children (Mr. Martin): My Department is aware that there is considerable medical literature relating to the use of implanted neurostimulators as a possible treatment for refractory angina. It understands, however, that no long-term randomised controlled trial has been carried out in that regard.

Inquiries were made of VHI which has advised that an application for insurance cover for spinal cord stimulators was previously considered. VHI has concluded, having carried out a literature review to identify both the clinical and cost effectiveness of this procedure, that randomised control trials were required to support its use. VHI has been keeping the issue under review and has informed my Department that it does not pro[495] pose to provide insurance cover for this treatment pending the outcome of such trials which demonstrate both the clinical and cost-effectiveness of spinal cord stimulators for specific conditions, vis-à-vis other therapies.

In such circumstances, it is a matter for each insurer to evaluate the medical knowledge and scientific evidence available in determining the question of whether or not it is appropriate to provide cover in relation to a particular treatment.