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Evidence to Improve Care

Intrathecal Drug Delivery Systems for Cancer Pain and Noncancer Pain


Ontario Health Technology Advisory Committee Recommendations

The Ontario Health Technology Advisory Committee recommends against the expansion of public funding for intrathecal drug delivery systems for patients with chronic pain due to advanced cancer

The Ontario Health Technology Advisory Committee recommends against the expansion of public funding for intrathecal drug delivery systems for patients with chronic non-malignant back pain

Read the full OHTAC Recommendation report



Some patients with chronic back pain do not feel sufficient relief with oral medications. For patients with back pain that is difficult to control, intrathecal drug delivery systems (a pain reliever drug delivered directly into the spine) are a potential treatment option.

Intrathecal drug delivery systems involve a pump connected to a small tube implanted in the spine. The system delivers drugs directly to the fluid surrounding the spinal cord (the intrathecal space). By doing so, the medication does not need to go through the digestive system, which may reduce side effects.


Health Quality Ontario Reviews Intrathecal Drug Delivery Systems

To see how effective intrathecal drug delivery systems are in managing chronic cancer or non-malignant back pain, we looked at studies that compared comprehensive pain management strategies that included these systems with strategies that did not.


Intrathecal Drug Delivery Systems for Cancer Pain: A Health Technology Assessment (PDF)
January 2016

Intrathecal Drug Delivery Systems for Noncancer Pain: A Health Technology Assessment (PDF)
January 2016


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry has no current plans to change funding for these systems.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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