alexa Healthcare Resource Utilization And Costs Of Spinal Cord Injury With Neuropathic Pain In A Medicare Population
ISSN: 2167-0846

Journal of Pain & Relief
Open Access

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Research Article

Healthcare Resource Utilization And Costs Of Spinal Cord Injury With Neuropathic Pain In A Medicare Population

Margolis JM1*, Juneau P1, Sadosky A2, Cappelleri JC3, Bryce TN4 and Nieshoff EC5
1Truven Health Analytics, Bethesda, MD, USA
2Pfizer Inc, New York, USA
3Pfizer Inc, Groton, CT, USA
4The Icahn School of Medicine at Mount Sinai, New York, USA
5Rehabilitation Institute of Michigan, Detroit, MI, USA
Corresponding Author : Jay Margolis
PharmD, Truven Health Analytics
332 Bryn Mawr Ave., Bala Cynwyd, PA 19004, USA
Tel: +1 610.667.4718
Fax: +1 610.667.4718
Received February 23, 2014; Accepted June 09, 2014; Published June 11, 2014
Citation: Margolis JM, Juneau P, Sadosky A, Cappelleri JC, Bryce TN, et al. (2014) Healthcare Resource Utilization and Costs of Spinal Cord Injury with Neuropathic Pain in a Medicare Population. J Pain Relief S3:007. doi: 10.4172/2167-0846.S3-007
Copyright: © 2014 Margolis JM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objective: Evaluation of healthcare resource utilization (HRU) and costs in patients with neuropathic pain (NeP) secondary to spinal cord injury (SCI) in a Medicare population.
Methods: Using data from the MarketScan Medicare Database between January 1, 2006 and June 30, 2011, patients with NeP following SCI (SCI-NeP cohort) were identified based on an ICD-9-CM diagnostic code indicative of SCI, and NeP (index event) within 12 months based on ICD-9-CM code 338.0x (central neuropathic pain) or a claim for an NeP-related antiepileptic or NeP-related antidepressant drug, and propensity score-matched to SCI patients without NeP (SCI-only). Pre-index demographic and clinical characteristics were compared between the cohorts. HRU and expenditures were compared for 12 months post-index. Generalized linear models and ordinary least squares models evaluated the association between characteristics and outcomes.
Results: The matched cohorts included 1,418 patients (approximately 54% male, mean age 77 years). During the 12-month follow-up period, SCI-NeP patients showed significantly greater use of evaluated medications (P < 0.01), and significantly higher HRU (P < 0.05), including 20% and 18% increased odds of hospitalization and emergency department visits, respectively. Mean (SD) total all-cause healthcare expenditures for this period adjusted for covariates showed an annual incremental economic burden of $6,808 (95% confidence interval $4,143, $9,764) per patient with NeP.
Conclusions: Medicare patients with NeP secondary to SCI have significantly higher HRU and costs relative to SCI patients without NeP. Medicare patients represent a population with special needs regarding therapeutic choices that may benefit from an integrated approach to NeP management.


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