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I costi del dolore cronico/ricorrente in medicina generale

Costs of chronic/recurrent pain in general practice



To estimate the cost of chronic pain in Italian general practice from a payer perspective.


A retrospective study of two months’ duration.


48 General Practitioners (GPs) in Italy recruited 543 patients who attended a consultation during the period January–September 2001. Afterwards, patients were classified in three groups according to drugs’ prescriptions: Group 1 (173 patients not treated with NSAIDs), Group 2 (285 patients treated with non selective NSAIDs only), and Group 3 (85 patients treated with at least one selective NSAID). Considered costs included drugs, diagnostic procedures, laboratory tests, and hospital admissions. GPs were asked to split all costs into two categories: i) costs related to pain; ii) costs related to gastrointestinal (GI) adverse events.

Main outcome measures and results

Patients of Group 3 were significantly older than the others and had a higher proportion of ostheoarthritis as diagnosis. Differences between mean costs per patient by group (Group 1 € 26.47, Group 2 € 103.67, Group 3 € 139.00) were significant. Costs of Group 3 were higher also when the analysis was limited to GI adverse events (Group 3 € 6.83, Group 2 € 4.42, Group 1 € 1.10).


This study is a first attempt to assess costs of chronic pain in Italy. Further studies with a longer time horizon should follow in the future to assess the robustness of results.

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  1. Crook J, Rideout E, Browne G. The prevalence of pain in a general population. Pain 1989; 37: 215–22

    Article  Google Scholar 

  2. Von Korff M, Dworkin S, Le Resche L, Kruger A. An epidemiological comparison of pain complaints. Pain 1988; 32: 173–83

    Article  Google Scholar 

  3. Kind P, Dolan P, Gudex C, Williams A. Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 1998; 316: 736–40

    PubMed  Article  CAS  Google Scholar 

  4. Bowsher D, Rigge M, Sopp L. Prevalence of chronic pain in the British population: a telephone survey of 1037 households. The Pain Clinic 1991; 4: 223–30

    Google Scholar 

  5. Brattberg G, Thorslund M, Wikman A. The prevalence of pain in the general population. The results of a postal survey in a county in Sweden. Pain 1989; 37: 215–22

    PubMed  Article  CAS  Google Scholar 

  6. Croft P, Righy AS, Boswell R, et al. The prevalence of chronic widespread pain in the general population. J Rheumatol 1993; 20: 710–13

    PubMed  CAS  Google Scholar 

  7. Crook J, Browne G. The prevalence of pain complaints in a general population. Pain 1984; 18: 299–314

    PubMed  Article  CAS  Google Scholar 

  8. James FR, Large RG, Bushnell JA, Wells JE. Epidemiology of pain in New Zealand. Pain 1991; 44: 279–83

    PubMed  Article  CAS  Google Scholar 

  9. Smith BH, Read JRM, Grimshaw JM, et al. Researching chronic pain: identification of a community based sample. The Pain Clinic 1996; 9: 73–6

    Google Scholar 

  10. Von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: an epidemiologic evaluation. Pain 1990; 40: 279–91

    Article  Google Scholar 

  11. Practice guidelines for chronic pain management. A report by the American Society of Anesthesiologists Task Force on Pain Management, Chronic Pain Section. Anesthesiology 1997; 86: 995–1004

    Google Scholar 

  12. Kuettner KE, Goldberg VM. Introduction. In: Kuettner KE, Goldberg VM, editors. Osteoarthritic Disorders. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1995: XXI–XXV

    Google Scholar 

  13. Reyes-Gibby CC, Aday LA, Cleeland C. Impact of pain on self-rated health in the community-dwelling older adults. Pain 2002; 95: 75–82

    PubMed  Article  Google Scholar 

  14. Librach SL. Managing chronic pain in family practice. Can Fam Physician 1993; 39: 539–44

    PubMed  CAS  Google Scholar 

  15. American Geriatrics Society. The management of chronic pain in older persons: AGS Panel on Chronic Pain in Older Persons. J Am Geriat Soc 1998; 46: 635–51

    Google Scholar 

  16. Magni G, Marchetti M, Moreschi C, et al. Chronic musculoskeletal pain and depressive symptoms in the National Health and Nutrition Examination. 1. Epidemiologic follow-up study. Pain 1993; 53: 163–8

    PubMed  Article  CAS  Google Scholar 

  17. Magni G, Caldieron C, Rigatti-Luchini S, Merskey H. Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st National Health and Nutrition Examination Survey data. Pain 1990; 43: 299–307

    PubMed  Article  CAS  Google Scholar 

  18. Parmelee PA, Katz IR, Lawton MP. The relation of pain to depression among institutionalised aged. J Gerontol. 1991; 46: P15–21

    PubMed  Article  CAS  Google Scholar 

  19. Cooner E, Amorosi S. The Study of Pain and Older Americans. Study conducted for the National Council on Aging. Study No. 628200. New York: Louis Harris, 1997

    Google Scholar 

  20. Borda IT. The spectrum of adverse gastrointestinal effects associated with nonsteroidal anti-inflammatory drugs. In: Borda IT, Koff RS, editors. NSAIDs: a profile of adverse effects. Philadelphia: Mosby-Year Book, 1992: 25–80

    Google Scholar 

  21. Hawkey CJ. Nonsteroidal anti-inflammatory drug gastropathy. Gastroenterology 2000; 119: 521–35

    PubMed  Article  CAS  Google Scholar 

  22. Bensen WG. Antiinflammatory and analgesic efficacy of COX-2 specific inhibition: from investigational trials to clinical experience. J Rheumatol Suppl 2000; 60: 17–24.

    PubMed  CAS  Google Scholar 

  23. Bajaj P, Bajaj P, Graven-Nielsen T, Arendt-Nielsen L. Osteoarthritis and its association with muscle hyperalgesia: an experimental controlled study. Pain 2001; 93: 107–14

    PubMed  Article  CAS  Google Scholar 

  24. Hunsche E, Chancellor JV, Bruce N. The burden of arthritis and nonsteroidal anti-inflammatory treatment: a European literature review. Pharmacoeconomics 2001; 19 (suppl. 1): 1–15.

    PubMed  Article  Google Scholar 

  25. Ministero della Sanità. Decreto Ministeriale n.150 del 22 luglio 1996. Prestazioni di assistenza specialistica ambulatoriale erogabili nell’ambito del Servizio Sanitario Nazionale e relative tariffe. Supplemento ordinario alla Gazzetta ufficiale n. 216 del 14 settembre 1996. Serie Generale.

  26. Ministero della Sanità. Decreto Ministeriale n.178 del 30 giugno 1997. Aggiornamento delle tariffe delle prestazioni di assistenza ospedaliera, di cui al Decreto Ministeriale 14 dicembre 1994. Supplemento ordinario alla Gazzetta ufficiale n. 209 del 8 Settembre 1997. Serie Generale.

  27. Russo P, Attanasio E, Baio G, et al. Una prima valutazione economica dell’impiego di rofecoxib versus FANS convenzionali nell’artrosi. PharmacoEconomics-Italian Research Articles 2001; 3(2): 81–9

    Google Scholar 

  28. Lucioni C, Chiroli S, Roggeri D, Annoni G. Analisi di costo della terapia con celecoxib vs FANS tradizionali nell’artrosi in Italia. PharmacoEconomics-Italian Research Articles 2003; 5(1): 23–34

    Google Scholar 

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Correspondence to Livio Garattini.

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Garattini, L., Caimi, V., Cipriani, S. et al. I costi del dolore cronico/ricorrente in medicina generale. Pharmacoeconomics-Ital-Res-Articles 6, 39–46 (2004).

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