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Healthcare costs associated with elderly chronic pain patients in primary care

  • Pharmacoeconomics
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

This study aimed to estimate the total healthcare costs associated with elderly chronic pain (CP) patients, define cost-related factors in this population, and examine cost evolution over two years.

Method

This is an ancillary study from the CP S.AGE subcohort, including non-institutionalized patients aged over 65 suffering from CP. 1190, 1108, 1042, and 950 patients were reviewed with available healthcare data at follow-up visits at 6, 12, 18, and 24 months, respectively. Healthcare components included medical and paramedical visits, medication prescription, and hospitalization.

Result

The mean total cost in the first semester was estimated at €2548 ± €8885 per patient. Hospitalization represented the largest cost component (50 %) followed by paramedical care (24 %), medications (21 %), and medical visits (5 %). Significant cost-associated factors were comorbidity (OR 1.49, 95 % CI 1.35–1.64), dependency in daily activities (OR 1.85, 95 % CI 1.39–2.47), probable depression (OR 1.71, 95 % CI 1.09–2.69), permanent pain (OR 1.48, 95 % CI 1.18–1.86), neuropathic pain (OR 1.94, 95 % CI 1.38–2.73), living alone (OR 1.45, 95 % CI 1.16–1.82), chronic back pain (OR 1.35, 95 % CI 1.07–1.71), and vertebral fracture/compression (OR 1.47, 95 % CI 1.08–2.01). Healthcare costs increased significantly by 48 % (p < 0.0001) during follow-up namely due to hospitalizations. Elevated costs were associated with a higher risk of future hospitalization (OR 1.95, CI 95 % 1.33–2.87).

Conclusion

Healthcare costs increased rapidly over time, largely due to hospitalization. Prevention strategies to limit hospitalizations in elderly appear to be the most useful in order to achieve cost savings in the future.

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Author contributions

Lazkani A: study design, data analysis, and manuscript preparation.

Becquemont L: study design, data analysis, and manuscript preparation.

Delespierre T: study design, data analysis, and manuscript preparation.

Bauduceau B: study design, manuscript revision, and approval of the final version for publication.

Pasquier F: study design, manuscript revision, and approval of the final version for publication.

Bertin P: study design, manuscript revision, and approval of the final version for publication.

Berrut G: study design, manuscript revision, and approval of the final version for publication.

Corruble E: study design, manuscript revision, and approval of the final version for publication.

Falissard B: study design, manuscript revision, and approval of the final version for publication.

Doucet J: study design, manuscript revision, and approval of the final version for publication.

Forette F: study design, manuscript revision, and approval of the final version for publication.

Hanon O: study design, manuscript revision, and approval of the final version for publication.

Benattar-Zibi L: study design, manuscript revision, and approval of the final version for publication.

Piedvache C: data analysis, manuscript revision, and approval of the final version for publication.

Conflicts of interest

Lazkani A has no conflict of interest.

Becquemont L received consulting fees from Sanofi-Aventis, Pfizer and Servier, and lecture fees from Genzyme, GlaxoSmithKline, Bristol-Myers Squibb, and Merck Sharp & Dohme; close family member working at Sanofi France.

Delespierre T has no conflict of interest.

Bauduceau B received consulting fees from Sanofi-Aventis, Bristol-Myers Squibb, Merck Sharp & Dohme, Roche, and Novo Nordisk.

Bertin P received consulting fees from Sanofi-Aventis, Pfizer, Ethypharm and Reckitt Benckiser, and speaking fees from Genevrier, Roche, Bristol-Myers Squibb, and Merck Sharp & Dohme.

Berrut G received fees from Sanofi, Lundbeck, Eisai, Novartis, MSD, Amgen, Boehringer Ingelheim, and Bayer.

Corruble E received consulting fees from Servier, Lundbeck, Sanofi-Aventis, Bristol Myers Squibb, and Eisai.

Doucet J received speaking fees from Novo Nordisk, consulting fees from Sanofi-Aventis, Novo Nordisk, and Merck Serono, and has a research partnership with Lilly.

Falissard B received consulting fees from Sanofi-Aventis, Servier, Roche, AstraZeneca, Grünenthal, Lilly, HRA, Boehringer Ingelheim, Bayer, Novartis, Genzyme, Stallergenes, Daiichi, Otsuka, and BMS.

Forette F received speaking and consulting fees from AstraZeneca, Bayer, BMS, Esaï, Exonhit, Fabre, Ipsen, Janssen-Cilag, Lilly, Lundbeck, Novartis, MSD, Merz, Pfizer, Roche, Sanofi-Aventis, Servier, Schwartz Pharma, Specia, Warner–Lambert, and Wyeth.

Hanon O received speaking and consulting fees from AstraZeneca, Bayer, BMS, Boehringer, Esaï, Exonhit, Janssen-Cilag, Lundbeck, Novartis, Pfizer, Sanofi-Aventis, and Servier.

Pasquier F is an investigator for Pfizer, Piramal, Roche, Lilly, Astra Zeneca, Noscira, Pharnext, Forum Pharmaceutical, and GE Healthcare and received consulting fees from Lilly, Novartis, Nuticia, and Sanofi.

Benattar-Zibi L has no conflict of interest.

Piedvache C has no conflict of interest.

Author information

Authors and Affiliations

  1. Pharmacology Department, Paris-Sud Faculty of Medicine, Paris-Sud University, AP-HP, Bicêtre Hospital, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre cedex, France

    Aida Lazkani, Tiba Delespierre, Celine Piedvache & Laurent Becquemont

  2. Endocrinology Department, Bégin Hospital, Saint-Mandé, France

    Bernard Bauduceau

  3. INSERM U 1171 Lille University Hospital, 59000, Lille, France

    Florence Pasquier

  4. Rheumatology Department, Limoges University Hospital, Limoges, France

    Philippe Bertin

  5. Clinical Gerontology, Nantes University Hospital, Nantes, France

    Gilles Berrut

  6. INSERM U 669, Paris-Sud University, Paris-Sud Faculty of Medicine, Psychiatry Department, Bicêtre University Hospital, AP-HP, Le Kremlin-Bicêtre, France

    Emmanuelle Corruble

  7. Internal Medicine, Geriatrics and Therapeutics, Saint Julien University Hospital, Rouen University, Rouen, France

    Jean Doucet

  8. INSERM U 669, Paris-Sud University, Paris-Sud Faculty of Medicine, Biostatistics Department, AP-HP, Paul Brousse Hospital, Le Kremlin-Bicêtre, France

    Bruno Falissard

  9. Paris Descartes University, National Gerontology Foundation, Paris, France

    Francoise Forette

  10. Geriatrics Department, Paris Descartes University, EA 4468, AP-HP, Broca Hospital, Paris, France

    Olivier Hanon

  11. Medical Director of ORPEA/CLINEA, Puteaux, France

    Linda Benattar-Zibi

Authors
  1. Aida Lazkani
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  2. Tiba Delespierre
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  12. Linda Benattar-Zibi
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Corresponding author

Correspondence to Aida Lazkani.

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Lazkani, A., Delespierre, T., Bauduceau, B. et al. Healthcare costs associated with elderly chronic pain patients in primary care. Eur J Clin Pharmacol 71, 939–947 (2015). https://doi.org/10.1007/s00228-015-1871-6

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  • DOI: https://doi.org/10.1007/s00228-015-1871-6

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