Pain is one of the most common and most distressing symptoms for adults and children with cancer. There are different types of pain medication and different ways of delivering medication: for example, by mouth or through injection. However, for some patients, commonly available medications and delivery routes do not provide enough pain control or cause undesirable side effects at high doses.

An intrathecal drug delivery system (IDDS) directly infuses pain medication into a fluid-filled space around the spinal cord called the intrathecal space. A pump is implanted under the skin and stores pain medication that is delivered to the intrathecal space by a catheter (a thin tube). It requires much lower doses of medication compared with medication that is delivered in other ways. Because of this, the use of an IDDS may reduce side effects and allow for more rapid and effective pain relief.

This health technology assessment looked at how effective, safe, and cost-effective IDDSs are for managing cancer pain in adults and children. It also looked at the budget impact of publicly funding these devices; the experiences, preferences, and values of adults and children with cancer pain; and the ethical considerations that arise in the context of IDDSs for managing cancer pain in adults and children.

The assessment was conducted in collaboration with the Canadian Agency for Drugs and Technologies in Health (CADTH).