Cost analysis of chronic pain due to musculoskeletal disorders in Chile

Abstract

The magnitude of the cost of chronic pain has been a matter of concern in many countries worldwide. The high prevalence, the cost it implies for the health system, productivity, and absenteeism need to be addressed urgently. Studies have begun describing this problem in Chile, but there is still a debt in highlighting its importance and urgency on contributing to chronic pain financial coverage. This study objective is to estimate the expected cost of chronic pain and its related musculoskeletal diseases in the Chilean adult population. We conducted a mathematical decision model exercise, Markov Model, to estimate costs and consequences. Patients were classified into severe, moderate, and mild pain groups, restricted to five diseases: knee osteoarthritis, hip osteoarthritis, lower back pain, shoulder pain, and fibromyalgia. Data analysis considered a set of transition probabilities to estimate the total cost, sick leave payment, and productivity losses. Results show that the total annual cost for chronic pain in Chile is USD 943,413,490, corresponding an 80% to the five diseases studied. The highest costs are related to therapeutic management, followed by productivity losses and sick leave days. Low back pain and fibromyalgia are both the costlier chronic pain-related musculoskeletal diseases. We can conclude that the magnitude of the cost in our country’s approach to chronic pain is related to increased productivity losses and sick leave payments. Incorporating actions to ensure access and financial coverage and new care strategies that reorganize care delivery to more integrated and comprehensive care could potentially impact costs in both patients and the health system. Finally, the impact of the COVID-19 pandemic will probably deepen even more this problem.

Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations

“… 15 Exact data from lower income countries are more difficult to acquire, but LBP is believed to be considerably costly in these countries as well. 16 …”

Focus on the impact of social factors and lifestyle on the disease burden of low back pain: findings from the global burden of disease study 2019

“…Suffering from persisting LBP may result in functional impairment in patients, affecting their quality of life and work productivity. The loss of productivity and increased sick leave caused by low back pain can further increase the economic burden on society [ 30 , 31 ]. Even after appropriate treatment, patients with low back pain may still exhibit poor prognosis [ 32 ].…”

Regular walking exercise prior to knee osteoarthritis reduces joint pain in an animal model

“…Chronic pain caused by knee OA not only leads to prolonged impairment and dysfunction; it also leads to a decline in an individual’s quality of life (QOL) [ 29 ] and socioeconomic loss [ 30 ]. Our present results provide important basic data showing that the practice of regular walking is useful as a primary prevention strategy for chronic knee OA pain.…”