Summary

Summary

  • The technology described in this briefing is the Axonics rechargeable sacral neuromodulation system. It is intended for use in overactive bladder syndrome and faecal incontinence.

  • The innovative aspects are that it is currently the only rechargeable sacral neuromodulation system and is designed to need less frequent surgical replacement than current non-rechargeable systems.

  • The intended place in therapy is as an alternative to non-rechargeable sacral neuromodulation devices in people with urinary or faecal dysfunction, who would be offered sacral neuromodulation in line with current NICE guidance.

  • The main points from the evidence summarised in this briefing are from 1 multicentre, post-marketing study in 51 adults with overactive bladder and 1 case series involving 5 people with faecal incontinence. They show that Axonics may provide effective sacral neuromodulation therapy, and that most people were satisfied with rechargeable therapy. Axonics was not compared with any other treatment.

  • Key uncertainty around the technology is that the available evidence is limited in quantity and quality, especially for use in faecal incontinence. Well-designed, comparative studies with larger numbers of patients and longer follow‑up would be helpful to confirm equivalence to standard care.

  • The cost of the Axonics sacral neuromodulation system is £475 for the trial phase, £9,210 for a permanent implant and £6,500 for a replacement implant (all excluding VAT). The resource impact would be similar for initial implantation but, if Axonics is shown to need replacing less often than current sacral neuromodulation systems, there could be less resource use from fewer procedures and associated complications. There is no relevant published evidence to support this.