Healthcare Utilization in People with Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy

Abstract

The results contribute to and expand current knowledge of the excess healthcare usage and costs of two prevalent peripheral neuropathic pain conditions and can be used in future studies of the cost-effectiveness of treatment and preventive interventions.

Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy

“…However, the opioid use was surprising, not only because these drugs were the most frequently prescribed pain medication including in the diabetes-only cohort, but also for the magnitude of their use, which ranged from 31.7% in the diabetes-only cohort, to N80% in the pDPN and severe pDPN cohorts. While a study by Dworkin et al (2011) also reported opioids were the most common pain medication in pDPN patients, studies by Hartsfield et al (Hartsfield et al, 2008) and Sadosky et al (Sadosky et al, 2013) reported anticonvulsants and antidepressants were the most common pain medications, respectively, followed by opioids. The data presented here indicate that there is discordance with current guidelines, which generally recommend opioids as second or third line treatment for neuropathic pain and pDPN in particular (Argoff et al, 2006;Attal et al, 2010;Dworkin, O'Connor, et al, 2010).…”

“…The presence of pDPN is associated with a substantial adverse impact on patient function, quality of life, and work productivity, and also results in an economic burden relative to the general population and to patients with diabetes without pDPN (Benbow, Wallymahmed, & Macfarlane, 1998;daCosta DiBonaventura, Cappelleri, & Joshi, 2011;Dworkin, Malone, Panarites, Armstrong, & Pham, 2010;Dworkin, Panarites, Armstrong, Malone, & Pham, 2011;Gore et al, 2005;Ritzwoller, Ellis, Korner, Hartsfield, & Sadosky, 2009;Stewart, Ricci, Chee, Hirsch, & Brandenburg, 2007). These effects have been reported to be greater as pain severity increases Gore et al, 2005;Sadosky et al, 2013).…”

Pain severity, interference, and prescription analgesic use among depressed, low-income homebound older adults

“…Untreated or undertreated pain and depression especially in late life can have a spiraling effect, and pain and/or pain perceptions can be greatly exacerbated by depression and vice versa (Arola, Nicholls, Mallen, & Thomas, 2010;Blyth et al, 2008;Parmelee, Harralson, McPherron, DeCoster, & Schumacher, 2012). The detrimental effects of comorbid chronic pain and depression include development or further deterioration of disability and health-related quality of life, social isolation, and increased use and cost of health services (Dworkin, Panarites, Armstrong, Malone, & Pham, 2011;Fritz, Brennan, Hunter, & Magel, 2013;Gibson & Lussier, 2012;Peng et al, 2009). Previous studies of depression treatment among older adults have also shown that treatment effect was blunted at higher levels of pain severity and/or interference with daily life and work inside and outside the home (Mavandadi et al, 2007;Thielke, Fan, Sullivan, & Un€ utzer, 2007).…”

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

“…Previous studies assessing HRU and direct costs among NeP subjects in the USA have relied mainly on medical claims data, and nearly all studies were limited to specific NeP conditions, such as painful diabetic peripheral neuropathy or post-herpetic neuralgia 4–7. For example, one medical claims analysis conducted among a sample of subjects with post-herpetic neuralgia in 2005 reported annual direct costs of US$1,623; another study, based on a survey of subjects with painful diabetic peripheral neuropathy conducted in 2008 reported total per patient annual direct costs to be US$5,786, US$7,762, and US$12,856 for patients with mild, moderate, and severe pain, respectively 6,9.…”