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Socioeconomic value of intervention for chronic pain

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Abstract

Purpose

The purpose of this study was to examine the cost-effectiveness of pain treatments in two pain centers in Japan.

Methods

The study population comprised 91 patients receiving various treatments for chronic pain, which were divided into three categories: (1) medication, (2) medication + nerve block, and (3) other modalities (exercise and/or pain education). Pain was assessed using the Pain Disability Assessment Scale (PDAS) score, Hospital Anxiety and Depression Scale (HADS) score, Pain Catastrophizing Scale (PCS) score, and EQ-5D score. First, the reliability of the EQ-5D score first assessed by evaluating the correlation this score with those of the other pain-related evaluation instruments, and then the cost effectiveness of the pain treatments was evaluated. Evaluation of medical costs was based on data provided from the Management Services of the hospital, which in turn were based on national health scheme medical treatment fees. The quality-adjusted life year (QALY) value was calculated from the EQ-5D score, converted to 12 months, and then used for cost-benefit analysis along with medical treatment fees.

Results

According to the recent IASP classification, more patients had chronic neuropathic pain (41) than chronic primary pain (37 patients) or chronic musculoskeletal pain (27 patients). There was a significant correlation between the EQ-5D score and the PDAS, HADS, and PCS scores, which demonstrated the reliability of the EQ-5D score. Significant improvement in the HADS, PCS, and EQ-5D scores was noted after 3 months of pain treatment. Calculation of the cost-effectiveness based on the estimated annual medical treatment cost and QALY revealed a mean value of US $45,879 ± 103,155 per QALY (median US $16,903), indicating adequate socioeconomic utility.

Conclusion

Based on our results, the EQ-5D is reliable for evaluating chronic pain in patients. The medico-economic balance was appropriate for all treatments provided in two comprehensive pain centers in Japan.

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References

  1. Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13:715–24.

    Article  PubMed  Google Scholar 

  2. Gannon B, Finn DP, O’Gorman D, Ruane N, McGuire BE. The cost of chronic pain: an analysis of a regional pain management service in Ireland. Pain Med. 2013;14:1518–28.

    Article  PubMed  Google Scholar 

  3. Knight T, Schaefer C, Chandran A, Zlateva G, Winkelmann A, Perrot S. Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States. Clinicoecon Outcomes Res. 2013;5:171–80.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Langley PC, Van Litsenburg C, Cappelleri JC, Carroll D. The burden associated with neuropathic pain in Western Europe. J Med Econ. 2013;16:85–95.

    Article  PubMed  Google Scholar 

  5. Maas ET, Juch JN, Groeneweg JG, Ostelo RW, Koes BW, Verhagen AP, van Raamt M, Wille F, Huygen FJ, van Tulder MW. Cost-effectiveness of minimal interventional procedures for chronic mechanical low back pain: design of four randomised controlled trials with an economic evaluation. BMC Musculoskelet Disord. 2012;13:260.

    Article  PubMed  PubMed Central  Google Scholar 

  6. North RB, Shipley J, Wang H, Mekhail N. A review of economic factors related to the delivery of health care for chronic low back pain. Neuromodulation. 2014[Suppl 17];2:69–76.

  7. Obradovic M, Ikenberg R, Hertel N, Antonanzas F, Galvez R, Liedgens H. Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs. Clin Ther. 2012;34:926–43.

    Article  PubMed  Google Scholar 

  8. Winkelmann A, Perrot S, Schaefer C, Ryan K, Chandran A, Sadosky A, Zlateva G. Impact of fibromyalgia severity on health economic costs: results from a European cross-sectional study. Appl Health Econ Health Policy. 2011;9:125–36.

    Article  PubMed  Google Scholar 

  9. Cardosa M, Osman ZJ, Nicholas M, Tonkin L, Williams A, Abd AK, Mohd AR, Dahari NM. Self-management of chronic pain in Malaysian patients: effectiveness trial with 1-year follow-up. Transl. Behav Med. 2012;2:30–7.

    Article  Google Scholar 

  10. Takura T, Yoshimatsu M, Sugimori H, Takizawa K, Furumatsu Y, Ikeda H, Kato H, Ogawa Y, Hamaguchi S, Fujikawa A, Satoh T, Nakajima Y. Cost-effectiveness analysis of percutaneous vertebroplasty for osteoporotic compression fractures. J Spinal Disord Tech. 2013;2013:16.

    Google Scholar 

  11. Takura T, Nakanishi T, Kawanishi H, Nitta K, Akizawa T, Hiramatsu M, Kawasaki T, Kukita K, Soejima H, Hirakata H, Yoshida T, Miyamoto T, Takahashi S. Cost-effectiveness of maintenance hemodialysis in Japan. Ther Apher Dial. 2015;9:441–9.

  12. Wielage R, Bansal M, Wilson K, Klein R, Happich M. Cost-effectiveness of duloxetine in chronic low back pain: a Quebec societal perspective. Spine (Phila Pa 1976). 2013;38:936–946.

  13. Manchikanti L, Falco FJ, Pampati V, Cash KA, Benyamin RM, Hirsch JA. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013;16:E129–43.

    PubMed  Google Scholar 

  14. Manchikanti L, Helm S 2nd, Pampati V, Racz GB. Cost utility analysis of percutaneous adhesiolysis in managing pain of post-lumbar surgery syndrome and lumbar central spinal stenosis. Pain Pract. 2015;15:414–22.

    Article  PubMed  Google Scholar 

  15. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Kosek E, Lavand’homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JW, Wang SJ. A classification of chronic pain for ICD-11. Pain. 2015;156:1003–7.

    PubMed  PubMed Central  Google Scholar 

  16. Edejer T, Baltussen R, Adam R, Hutubessy R, Acharya A, Evans DB, Murray CJL, Methods for generalized cost-effectiveness analysis. In: WHO Guide to cost-effectiveness analysis. 2003. World Health Organization, Geneva, pp 3–16.

  17. Takura T. Cost-effectiveness of hemodialysis in Japan. Contrib Nephrol. 2015;185:124–31.

    PubMed  Google Scholar 

  18. Takura T, Hayashi M, Muragaki Y, Iseki H, Uetsuka Y. Study on medical economic evaluation methods for metastatic brain tumors therapy (in Japanese with English abstract). No Shinkei Geka (Jpn J Anesthesiol). 2010;38:629–37.

    Google Scholar 

  19. EuroQol Group. EuroQol–a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.

    Article  Google Scholar 

  20. Luo N, Chew LH, Fong KY, Koh DR, Ng SC, Yoon KH, Vasoo S, Li SC, Thumboo J. A comparison of the EuroQol-5D and the Health Utilities Index mark 3 in patients with rheumatic disease. J Rheumatol. 2003;30:2268–74.

    PubMed  Google Scholar 

  21. Schweikert B, Hahmann H, Leidl R. Validation of the EuroQol questionnaire in cardiac rehabilitation. Heart. 2006;92:62–7.

    Article  CAS  PubMed  Google Scholar 

  22. Takura T, Nakanishi T, Kawanishi H, Nitta K, Akizawa T, Hiramatsu M, Kawasaki T, Kukita K, Soejima H, Hirakata H, Yoshida T, Miyamoto T, Takahashi S. Cost-Effectiveness of Maintenance Hemodialysis in Japan. Ther Apher Dial. 2015;19:441–9.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to expression their gratitude to the staff of Osaka University Hospital and Aichi Medical University Hospital who kindly cooperated in this study despite their busy schedule.

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Authors and Affiliations

  1. Department of Health Care Economics and Industrial Policy, Graduate School of Medicine, Osaka University, Osaka, Japan

    Tomoyuki Takura

  2. Department of Pain Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka Suita, Osaka, 565-0871, Japan

    Masahiko Shibata

  3. Aichi Medical University School of Medicine, Multidisciplinary Pain Center, Aichi, Japan

    Shinsuke Inoue & Takahiro Ushida

  4. Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yoichi Matsuda & Hironobu Uematsu

  5. Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan

    Keiko Yamada

Authors
  1. Tomoyuki Takura
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  2. Masahiko Shibata
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  3. Shinsuke Inoue
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  4. Yoichi Matsuda
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  5. Hironobu Uematsu
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  6. Keiko Yamada
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  7. Takahiro Ushida
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Corresponding author

Correspondence to Masahiko Shibata.

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The authors declare no conflict of interest.

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Takura, T., Shibata, M., Inoue, S. et al. Socioeconomic value of intervention for chronic pain. J Anesth 30, 553–561 (2016). https://doi.org/10.1007/s00540-016-2162-9

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  • DOI: https://doi.org/10.1007/s00540-016-2162-9

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