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.