Promotion and economic considerations of domestic Vagus nerve stimulation within the Chinese three-tier epilepsy center system
- 1Department of Neurology, West China Hospital of Sichuan University
- 2Financial Settlement Department, West China Hospital of Sichuan University
Abstract
Background: Epilepsy affects approximately 10 million people in China, with about 30% developing drug-resistant epilepsy (DRE). Vagus Nerve Stimulation (VNS) is an established neuromodulation therapy for DRE. Domestic VNS devices completed clinical trials in 2014 and entered clinical use in 2016. This study synthesizes clinical outcomes, promotion pathways, and economic considerations of domestic VNS devices within the Chinese three-tier epilepsy center network established by the China Association Against Epilepsy (CAAE).
Methods: This narrative synthesis integrates data from previously published multicenter prospective real-world studies, CAAE accreditation records, market research, and health economics literature. Clinical outcome data were derived from studies encompassing 124 adult and 87 pediatric patients with DRE across 86 epilepsy centers. A cost comparison between domestic and imported VNS devices was performed based on market data and implantation volumes from 2022–2025.
Results: In adults, responder rates (≥50% seizure reduction) increased progressively from 35.4% at 1 month to 76.6% at 12 months post-implantation, with seizure-free rates reaching 10.9%. In pediatric patients, according to the available follow-up data, ≥50% responder rates (combining seizure freedom, 75% reduction, and 50% reduction) were 43.4% at visit 2, 40.6% at visit 3, 56.6% at visit 4, and 55.8% at visit 5; seizure freedom rates ranged from 1.1 to 9.3% across visits. Significant improvements were observed in sleep quality (PSQI: 5.43 → 4.44), depression (NDDI-E: 6.49 → 4.83), anxiety (GAD-7: 7.15 → 4.95), and quality of life (QOLIE-31: 54.40 → 61.33). Adverse events were mild and transient, primarily voice changes (20.3%) and cough (8.6%). The three-tier network comprises 526 centers (45 Tier-3, 259 Tier-2, 222 Tier-1) with standardized protocols and telemedicine platforms.
Conclusion: Domestic VNS demonstrates encouraging efficacy, favorable safety, and improvements in comorbidities in both adult and pediatric DRE populations within the CAAE three-tier network. The network provides a structured framework for standardized application. However, the evidence is limited by the uncontrolled design of the primary studies, short follow-up, and the absence of a formal cost-effectiveness analysis. Prospective comparative clinical and economic validation is warranted.
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BibTeX
@article{ou2026promotion,
title = {{Promotion and economic considerations of domestic Vagus nerve stimulation within the Chinese three-tier epilepsy center system}},
author = {Zhujing Ou and Zhijun Le and Jiayu Mi and Raowei Yan and Wenyu Liu and Enhui Zhang and Weixi Xiong and Deng Chen and Dong Zhou and Rui Xue and Xintong Wu},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1963297},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1963297/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Promotion and economic considerations of domestic Vagus nerve stimulation within the Chinese three-tier epilepsy center system
AU - Zhujing Ou
AU - Zhijun Le
AU - Jiayu Mi
AU - Raowei Yan
AU - Wenyu Liu
AU - Enhui Zhang
AU - Weixi Xiong
AU - Deng Chen
AU - Dong Zhou
AU - Rui Xue
AU - Xintong Wu
PY - 2026
DA - 2026/10/21
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1963297
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1963297/full
AB - Background: Epilepsy affects approximately 10 million people in China, with about 30% developing drug-resistant epilepsy (DRE). Vagus Nerve Stimulation (VNS) is an established neuromodulation therapy for DRE. Domestic VNS devices completed clinical trials in 2014 and entered clinical use in 2016. This study synthesizes clinical outcomes, promotion pathways, and economic considerations of domestic VNS devices within the Chinese three-tier epilepsy center network established by the China Association Against Epilepsy (CAAE). Methods: This narrative synthesis integrates data from previously published multicenter prospective real-world studies, CAAE accreditation records, market research, and health economics literature. Clinical outcome data were derived from studies encompassing 124 adult and 87 pediatric patients with DRE across 86 epilepsy centers. A cost comparison between domestic and imported VNS devices was performed based on market data and implantation volumes from 2022–2025. Results: In adults, responder rates (≥50% seizure reduction) increased progressively from 35.4% at 1 month to 76.6% at 12 months post-implantation, with seizure-free rates reaching 10.9%. In pediatric patients, according to the available follow-up data, ≥50% responder rates (combining seizure freedom, 75% reduction, and 50% reduction) were 43.4% at visit 2, 40.6% at visit 3, 56.6% at visit 4, and 55.8% at visit 5; seizure freedom rates ranged from 1.1 to 9.3% across visits. Significant improvements were observed in sleep quality (PSQI: 5.43 → 4.44), depression (NDDI-E: 6.49 → 4.83), anxiety (GAD-7: 7.15 → 4.95), and quality of life (QOLIE-31: 54.40 → 61.33). Adverse events were mild and transient, primarily voice changes (20.3%) and cough (8.6%). The three-tier network comprises 526 centers (45 Tier-3, 259 Tier-2, 222 Tier-1) with standardized protocols and telemedicine platforms. Conclusion: Domestic VNS demonstrates encouraging efficacy, favorable safety, and improvements in comorbidities in both adult and pediatric DRE populations within the CAAE three-tier network. The network provides a structured framework for standardized application. However, the evidence is limited by the uncontrolled design of the primary studies, short follow-up, and the absence of a formal cost-effectiveness analysis. Prospective comparative clinical and economic validation is warranted.
SN - 1664-2295
ER -