The reported prevalence of pain in these five countries represents a substantial burden to individuals, employers, healthcare systems and society in general. The fact that one in five of the adult population has experienced pain presents a major policy challenge. This would involve not only reducing the prevalence of pain - where chronic pain may be considered a disease in its own right - but to co-ordinate pain management programs across a range of disease states and socio-economic groups.

For the five largest EU countries, the societal burden of pain is considerable. The experience of pain far outweighs the contribution of more traditional explanations of HRQoL deficits as well as being the primary factor associated with increased provider visits, emergency room visits and hospitalizations.

The presence of NeP is associated with an increased disease burden in the chronic pain population. This is seen in terms of HRQoL, health status, employment experience, and direct medical costs.

The experience of pain, in particular severe daily pain, has a substantial negative association with labor force participation in these five European countries as well as reported absenteeism and presenteeism. As a measure of health status, it clearly outweighs other health status measures. Whether or not pain is considered as a disease in its own right, the experience of chronic pain, as defined here, presents policy makers with a major challenge. Programs to relieve the burden of pain in the community clearly have the potential for substantial benefits from societal, individual and employer perspectives.

The results of this study suggest that HCV can be a substantial burden on patients in terms of quality of life in both physical and mental health measures. In addition, HCV can be a significant cost driver in terms of health-care use and lost productivity.