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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 E-mail: jay.margolis@truvenhealth.com |
| 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. | |
Abstract
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.
