• Peter W Park, Richard D Dryer, Rozelle Hegeman-Dingle, Jack Mardekian, Gergana Zlateva, Greg G Wolff, and Lois E Lamerato.
• Pfizer Inc., New York, New York, U.S.A.
• Pain Pract. 2016 Nov 1; 16 (8): 1001-1011.

ObjectivesTo estimate all-cause healthcare resource utilization and costs among chronic pain patients within an integrated healthcare delivery system in the United States.MethodsElectronic medical records and health claims data from the Henry Ford Health System were used to determine healthcare resource utilization and costs for patients with 24 chronic pain conditions. Patients were identified by ≥ 2 ICD-9-CM codes ≥ 30 days apart from January to December, 2010; the first ICD-9 code was the index event. Continuous coverage for 12 months pre- and postindex was required. All-cause direct medical costs were determined from billing data.ResultsA total of 12,165 patients were identified for the analysis. After pharmacy, the most used resource was outpatient visits, with a mean of 18.8 (SD 13.2) visits per patient for the postindex period; specialty visits accounted for 59.0% of outpatient visits. Imaging was utilized with a mean of 5.2 (SD 5.5) discrete tests per patient, and opioids were the most commonly prescribed medication (38.7%). Annual direct total costs for all conditions were $386 million ($31,692 per patient; a 40% increase from the pre-index). Pharmacy costs comprised 14.3% of total costs, and outpatient visits were the primary cost driver.ConclusionsChronic pain conditions impose a substantial burden on the healthcare system, with musculoskeletal conditions associated with the highest overall costs. Costs appeared to be primarily related to use of outpatient services. This type of research supports integrated delivery systems as a source for assessing opportunities to improve patient outcomes and lower the costs for chronic pain patients.© 2015 World Institute of Pain.

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