A burden of illness study for neuropathic pain in Europe

Abstract

PurposeNeuropathic pain (NP) is often severe and represents a major humanistic and economic burden. This study aimed at providing insight on this burden across France, Germany, Italy, Spain, and the UK, considering direct and indirect costs, productivity loss, and humanistic impact on patients and their families.MethodsPhysician questionnaires provided data on patients presenting with NP covering demographics, sick leave and retirement, number of consultations, drug treatments, and surgical procedures. Patients provided further demographic and disease-related data and completed the Work Productivity and Activity Impairment (WPAI), the EuroQol 5-Dimension (EQ-5D), and the Brief Pain Inventory (BPI) questionnaires. All health-related direct unitary costs were collected from relevant country-specific sources and adjusted to 2012 prices (€) where necessary. A subgroup analysis of costs based on diabetic peripheral neuropathy (n=894), fibromyalgia (n=300), and low back pain (n=963) was performed.FindingsAbout 413 physicians completed a total of 3,956 patient records forms. Total annual direct health-care costs per patient ranged from €1,939 (Italy) to €3,131 (Spain). Annual professional caregiver costs ranged from €393 (France) to €1,242 (UK), but this only represented a small proportion of total care because much care is provided by family or friends. Sick leave costs ranged from €5,492 (UK) to €7,098 (France), with 10%–32% patients prevented from working at some point by NP. Total cost (including direct and indirect costs) of NP per patient was €10,313 in France (69% of the total cost), €14,446 in Germany (78%), €9,305 in Italy (69%), €10,597 in Spain (67%), and €9,685 in the UK (57%). Indirect costs (ie, sick leave) constituted the majority of costs in all five countries: €7,098 in France, €11,232 in Germany, €6,382 in Italy, €7,066 in Spain, and €5,492 in the UK. In the subgroup analysis, total annual direct costs per patient were highest for neuropathic back pain and radiculopathy, and lowest for fibromyalgia. Mean WPAI score range was 34.4–56.1; BPI interference was 4.1–4.8; and EQ-5D was 0.57–0.74. The results suggest that a significant proportion of the patient’s work time in the previous week was affected by NP, and these are relatively high compared with other diseases such as diabetes, respiratory conditions, and arthritis.ImplicationsDespite differences in practice between countries, these findings suggest a high opportunity cost for society in terms of lost work and productivity due to NP. The wider costs appear significantly higher to patients, carers/families, and society as a whole than to the health system alone.

The Impact of Chronic Discogenic Low Back Pain: Costs and Patients’ Burden

“…In 2007, the costs for CLBP represented 0.6% of the gross national product in the Netherlands [ 7 ]. Direct healthcare costs are, for instance, caused by patients searching for pain treatment [ 2 , 5 , 8 , 9 ]. Indirect (societal) costs represent secondary consequences of CLBP, the losses resulting from morbidity or disability, mainly caused by work absenteeism and informal caregiving [ 10 , 11 ].…”

Depression as a mediator of quality of life in patients with neuropathic pain: A cross‐sectional study

“…chronic pain, depression, mediation effect, neuropathic pain, nurse, nursing, pain, pain nursing practice, quality of life Kong, patients with NeP had more severe pain intensity, more pain descriptors, worse sleep quality and more lost workdays than those chronic pain patients without NeP (Inoue et al, 2017;Wong, Choi, & Cheung, 2018). In Europe and America, poor QoL in patients with NeP constitutes a heavy illness burden for patients and their caregivers or family members (Liedgens, Obradovic, De Courcy, Holbrook, & Jakubanis, 2016;Schaefer et al, 2014). As a result, improving QoL of patients with NeP is an important issue in nursing practice.…”

Safety Implications of Low-Dose Amitriptyline in Neuropathic Pain

“…Neuropathic pain is "caused by a lesion or disease of the somatosensory system", in contrast to the nociceptive origin of chronic pain arising from damage to non-neural tissue [1]. Population prevalence of pain with neuropathic properties is estimated to be around 7-10 percent [2], although indications point towards 20 percent of adults in Europe being potentially affected [3]. The origin of neuropathic pain is complex with known causes including diabetic neuropathy, postherpetic neuralgia, amputations, trauma, and HIV infection.…”