Pain severity and the economic burden of neuropathic pain in the United States: BEAT Neuropathic Pain Observational Study

Caroline Schaefer, Alesia Sadosky, Rachael Mann, Shoshana Daniel, Bruce Parsons, Michael Tuchman, Alan Anschel, Brett R. Stacey, Srinivas Nalamachu, Edward Nieshoff

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: As with many chronic conditions, patients with neuropathic pain (NeP) are high consumers of health care resources. However, limited literature exists on the economic burden of NeP, including its impact on productivity. The aim of this study was to characterize health care resource utilization, productivity, and costs associated with NeP by pain severity level in US adults.

Methods: Subjects (n=624) with painful diabetic peripheral neuropathy, human immunodeficiency virus-related peripheral NeP, post-trauma/post-surgical NeP, spinal cord injury with NeP, chronic low back pain with NeP, and small fiber neuropathy were recruited during routine office visits to US community-based general practitioners and specialists. Clinicians captured clinical characteristics, NeP-related medications, and health care resource utilization based on 6-month retrospective medical chart review. Subjects completed questionnaires on demographics, pain/symptoms, costs, and productivity. Brief Pain Inventory pain severity scores were used to classify subjects by mild, moderate, or severe pain. Annualized NeP-related costs (adjusted for covariates) were estimated, and differences across pain severity groups were evaluated.

Results: In total, 624 subjects were recruited (mean age 55.5±13.7 years; 55.4% male), and 504/624 (80.8%) reported moderate or severe pain. Statistically significant differences were observed across pain severity levels for number of comorbidities, prescription medications, physician office visits, and lost productivity (all P≤0.0001). At all pain severity levels, indirect costs were the primary cost driver. After adjusting for demographic and clinical variables, total mean (95% confidence interval [CI]) annualized direct medical costs to payers, direct costs to subjects, and indirect costs per subject were US$6,016 (95% CI 5,316–6,716), US$2,219 (95% CI 1,919–2,519), and US$19,000 (95% CI 17,197–20,802), respectively, with significant differences across pain severity levels.

Conclusion: Subjects with NeP, mainly those showing moderate or severe pain, had significant associations between pain severity and NeP-related health care resource utilization, productivity, and costs. The economic burden, particularly indirect costs, was highest among those with severe pain and higher than previously reported in studies of specific NeP conditions.

Original languageEnglish (US)
Pages (from-to)483-496
Number of pages14
JournalClinicoEconomics and Outcomes Research
Volume6
DOIs
StatePublished - Oct 29 2014

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Neuralgia
Observational Studies
Economics
Pain
Costs and Cost Analysis
Health Resources
Patient Acceptance of Health Care
Confidence Intervals
Office Visits
Observational study
Burden
Severity
Demography
Physicians' Offices
Diabetic Neuropathies
Peripheral Nervous System Diseases
Low Back Pain
Spinal Cord Injuries
General Practitioners
Prescriptions

Keywords

  • Burden of illness
  • Health care costs
  • Health care resource use
  • Neuropathic pain management
  • Productivity

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

Cite this

Pain severity and the economic burden of neuropathic pain in the United States : BEAT Neuropathic Pain Observational Study. / Schaefer, Caroline; Sadosky, Alesia; Mann, Rachael; Daniel, Shoshana; Parsons, Bruce; Tuchman, Michael; Anschel, Alan; Stacey, Brett R.; Nalamachu, Srinivas; Nieshoff, Edward.

In: ClinicoEconomics and Outcomes Research, Vol. 6, 29.10.2014, p. 483-496.

Research output: Contribution to journalArticle

Schaefer, C, Sadosky, A, Mann, R, Daniel, S, Parsons, B, Tuchman, M, Anschel, A, Stacey, BR, Nalamachu, S & Nieshoff, E 2014, 'Pain severity and the economic burden of neuropathic pain in the United States: BEAT Neuropathic Pain Observational Study', ClinicoEconomics and Outcomes Research, vol. 6, pp. 483-496. https://doi.org/10.2147/CEOR.S63323
Schaefer, Caroline ; Sadosky, Alesia ; Mann, Rachael ; Daniel, Shoshana ; Parsons, Bruce ; Tuchman, Michael ; Anschel, Alan ; Stacey, Brett R. ; Nalamachu, Srinivas ; Nieshoff, Edward. / Pain severity and the economic burden of neuropathic pain in the United States : BEAT Neuropathic Pain Observational Study. In: ClinicoEconomics and Outcomes Research. 2014 ; Vol. 6. pp. 483-496.
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abstract = "Background: As with many chronic conditions, patients with neuropathic pain (NeP) are high consumers of health care resources. However, limited literature exists on the economic burden of NeP, including its impact on productivity. The aim of this study was to characterize health care resource utilization, productivity, and costs associated with NeP by pain severity level in US adults.Methods: Subjects (n=624) with painful diabetic peripheral neuropathy, human immunodeficiency virus-related peripheral NeP, post-trauma/post-surgical NeP, spinal cord injury with NeP, chronic low back pain with NeP, and small fiber neuropathy were recruited during routine office visits to US community-based general practitioners and specialists. Clinicians captured clinical characteristics, NeP-related medications, and health care resource utilization based on 6-month retrospective medical chart review. Subjects completed questionnaires on demographics, pain/symptoms, costs, and productivity. Brief Pain Inventory pain severity scores were used to classify subjects by mild, moderate, or severe pain. Annualized NeP-related costs (adjusted for covariates) were estimated, and differences across pain severity groups were evaluated.Results: In total, 624 subjects were recruited (mean age 55.5±13.7 years; 55.4{\%} male), and 504/624 (80.8{\%}) reported moderate or severe pain. Statistically significant differences were observed across pain severity levels for number of comorbidities, prescription medications, physician office visits, and lost productivity (all P≤0.0001). At all pain severity levels, indirect costs were the primary cost driver. After adjusting for demographic and clinical variables, total mean (95{\%} confidence interval [CI]) annualized direct medical costs to payers, direct costs to subjects, and indirect costs per subject were US$6,016 (95{\%} CI 5,316–6,716), US$2,219 (95{\%} CI 1,919–2,519), and US$19,000 (95{\%} CI 17,197–20,802), respectively, with significant differences across pain severity levels.Conclusion: Subjects with NeP, mainly those showing moderate or severe pain, had significant associations between pain severity and NeP-related health care resource utilization, productivity, and costs. The economic burden, particularly indirect costs, was highest among those with severe pain and higher than previously reported in studies of specific NeP conditions.",
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AU - Mann, Rachael

AU - Daniel, Shoshana

AU - Parsons, Bruce

AU - Tuchman, Michael

AU - Anschel, Alan

AU - Stacey, Brett R.

AU - Nalamachu, Srinivas

AU - Nieshoff, Edward

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N2 - Background: As with many chronic conditions, patients with neuropathic pain (NeP) are high consumers of health care resources. However, limited literature exists on the economic burden of NeP, including its impact on productivity. The aim of this study was to characterize health care resource utilization, productivity, and costs associated with NeP by pain severity level in US adults.Methods: Subjects (n=624) with painful diabetic peripheral neuropathy, human immunodeficiency virus-related peripheral NeP, post-trauma/post-surgical NeP, spinal cord injury with NeP, chronic low back pain with NeP, and small fiber neuropathy were recruited during routine office visits to US community-based general practitioners and specialists. Clinicians captured clinical characteristics, NeP-related medications, and health care resource utilization based on 6-month retrospective medical chart review. Subjects completed questionnaires on demographics, pain/symptoms, costs, and productivity. Brief Pain Inventory pain severity scores were used to classify subjects by mild, moderate, or severe pain. Annualized NeP-related costs (adjusted for covariates) were estimated, and differences across pain severity groups were evaluated.Results: In total, 624 subjects were recruited (mean age 55.5±13.7 years; 55.4% male), and 504/624 (80.8%) reported moderate or severe pain. Statistically significant differences were observed across pain severity levels for number of comorbidities, prescription medications, physician office visits, and lost productivity (all P≤0.0001). At all pain severity levels, indirect costs were the primary cost driver. After adjusting for demographic and clinical variables, total mean (95% confidence interval [CI]) annualized direct medical costs to payers, direct costs to subjects, and indirect costs per subject were US$6,016 (95% CI 5,316–6,716), US$2,219 (95% CI 1,919–2,519), and US$19,000 (95% CI 17,197–20,802), respectively, with significant differences across pain severity levels.Conclusion: Subjects with NeP, mainly those showing moderate or severe pain, had significant associations between pain severity and NeP-related health care resource utilization, productivity, and costs. The economic burden, particularly indirect costs, was highest among those with severe pain and higher than previously reported in studies of specific NeP conditions.

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