NICE medical technology guidance finds system is cheaper and leads to faster improvement in symptoms, and fewer acute episodes
The XprESS multi-sinus dilation system is said to improve outcomes and save the NHS money
The National Institute of Health and Care Excellence (NICE) has issued final medical technology guidance supporting the use of the XprESS multi-sinus dilation system for treating chronic sinusitis after alternative medical treatment has failed.The guidance recommends that XprESS should only be used in patients with uncomplicated chronic sinusitis who do not have nasal polyps.
The evidence considered finds that treatment with XprESS leads to a rapid and sustained improvement in chronic symptoms, fewer acute episodes, and improved quality of life, which is comparable to functional endoscopic sinus surgery (FESS).
In addition to being associated with faster recovery times than FESS, the estimated saving per patient is £152.
The XprESS multi sinus dilation system from Entellus Medical is a sterile, single use device for treating chronic sinusitis.
The committee considered that XprESS has the potential to treat uncomplicated chronic sinusitis earlier in disease progression than is currently available in the NHS
The system comprises a balloon tipped device with a reshapeable end that is inserted through the nose into the maxillary, frontal, or sphenoidal sinuses. XprESS also includes an inflation syringe, bending tool and two extension lines to provide irrigation.
The balloon is manipulated into the bony sinus outflow tracts (ostia) and inflated with saline. This reshapes and opens the ostia by displacing adjacent bone and paranasal sinus structures, allowing the sinuses to drain more effectively.
The system is available in three variants, XprESS Ultra, LoProfile and Pro, which differ in the dimensions of the suction tip and the balloon diameter and length.
It costs £900, but the company is offering a reduction to £820 for centres that order 50 or more units in a year.
The guidance states: “The committee concluded from the evidence presented that XprESS is a clinically non inferior, but less-invasive, alternative to functional endoscopic sinus surgery (FESS) in patients with uncomplicated chronic sinusitis. Compared with FESS, it may lead to faster recovery times and carries a lower risk of some complications.
The committee concluded from the evidence presented that XprESS is a clinically non inferior, but less-invasive, alternative to functional endoscopic sinus surgery
“The committee concluded that cost savings are plausible, but depend on the device cost of XprESS, how long a FESS procedure takes, and the proportion of XprESS procedures that can be done in an outpatient setting using local anaesthetic.
“The committee considered that XprESS has the potential to treat uncomplicated chronic sinusitis earlier in disease progression than is currently available in the NHS. As such, it may improve quality of life and clinical outcomes, as well as reduce surgical waiting lists.
Click here for the full guidance.