Departments of Anesthesiology and Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
J Pain. 2010 Apr;11(4):360-8. doi: 10.1016/j.jpain.2009.08.005. Epub 2009 Oct 22.
Knowledge of the health care costs associated with neuropathic pain is limited. Existing studies have not directly compared the health care costs of different neuropathic pain conditions, and patients with neuropathic pain have not been compared with control subjects with the same underlying conditions (for example, diabetes). To determine health care costs associated with postherpetic neuralgia (PHN) and painful diabetic peripheral neuropathy (DPN), patients with these conditions were selected from 2 different administrative databases of health care claims and respectively matched to control subjects who had a diagnosis of herpes zoster without persisting pain or a diagnosis of diabetes without neurological complications using propensity scores for demographic and clinical factors. Total excess health care costs attributable to PHN and painful DPN and excess costs for inpatient care, outpatient/professional services, and pharmacy expenses were calculated. The results indicated that the annual excess health care costs associated with peripheral neuropathic pain in patients of all ages range from approximately $1600 to $7000, depending on the specific pain condition. Total excess health care costs associated with painful DPN were substantially greater than those associated with PHN, which might reflect the great medical comorbidity associated with DPN.
The data demonstrate that the health care costs associated with 1 peripheral neuropathic pain condition cannot be extrapolated to other neuropathic pain conditions. The results also increase understanding of the economic burden of PHN and painful DPN and provide a basis for evaluating the impact on health care costs of new interventions for their treatment and prevention.
对与神经性疼痛相关的医疗保健费用的了解有限。现有研究并未直接比较不同神经性疼痛状况的医疗保健费用，并且神经性疼痛患者与具有相同潜在疾病（例如糖尿病）的对照受试者也没有进行比较。为了确定带状疱疹后神经痛（PHN）和痛性糖尿病周围神经病变（DPN）相关的医疗保健费用，从两个不同的医疗保健索赔行政数据库中选择了患有这些疾病的患者，并使用倾向评分分别针对人口统计学和临床因素，将他们与没有持续疼痛的带状疱疹或没有神经并发症的糖尿病诊断相匹配的对照受试者进行匹配。计算了归因于 PHN 和痛性 DPN 的总超额医疗保健费用以及住院、门诊/专业服务和药房费用的超额费用。结果表明，所有年龄段的患者中，与周围神经性疼痛相关的年度超额医疗保健费用约为 1600 至 7000 美元，具体取决于特定的疼痛状况。与痛性 DPN 相关的总超额医疗保健费用大大超过了与 PHN 相关的费用，这可能反映了 DPN 与巨大的医疗合并症有关。
这些数据表明，一种周围神经性疼痛状况相关的医疗保健费用不能推断用于其他神经性疼痛状况。结果还增加了对 PHN 和痛性 DPN 的经济负担的理解，并为评估新的干预措施对其治疗和预防对医疗保健成本的影响提供了依据。
