Medical Costs of Chronic Musculoskeletal Pain in Italy
- 26 Downloads
Background and objectives: Musculoskeletal system problems are responsible for more than two-thirds of painful conditions in primary care. However, only one published study, conducted in Finland, has analysed the costs of managing musculoskeletal pain as a whole in primary care. This study analysed the costs of diagnosing and treating chronic musculoskeletal pain in primary care in Italy. A secondary aim of the study was to assess the impact of different drug treatment patterns on medical costs associated with musculoskeletal pain.
Methods: Chronic pain of musculoskeletal origin was defined as continuous or recurrent pain persisting over 3 months with involvement of the musculoskeletal system, i.e. arising from primary musculoskeletal disorders or from the late consequences of external events (injuries, medical care or surgery). A total of 52 general practitioners (GPs) recruited 581 patients. We focussed on the differences between patients treated (410) and not treated (171) with drugs. Within the treated group, we also analysed subgroups given non-selective NSAID-based therapy (subgroup A, 169 patients) or cyclo-oxygenase-2 (COX-2) inhibitor-based therapy (subgroup B, 52 patients).
Results: The annual average cost of treating a patient with chronic musculoskeletal pain was €212.60. Hospital admissions and GP consultations were the largest cost components, both accounting for around a quarter of the total cost. Not surprisingly, the treated group included older patients, who had more co-morbidities and more severe pain. This was associated with annual costs more than four times those of untreated patients (€274.50 vs €63.90, respectively). Subgroups A and B did not differ with respect to major demographic and clinical variables except in relation to mean age (63 vs 70 years, respectively; p = 0.037). They had similar per-patient costs (€186.20 vs €172.90), although these totals comprised a different mix of components.
Conclusion: The analysis showed that the annual average cost of treatment of chronic musculoskeletal pain in Italy varied considerably depending on whether drug treatment was used. COX-2 inhibitors and traditional NSAIDs had similar per-patient costs, although this similarity stemmed from a different mix of components.
KeywordsFibromyalgia Musculoskeletal Pain Resource Consumption Chronic Musculoskeletal Pain Traditional NSAID
Pharmacia Italia S.p.A. provided financial support for this study. The authors have no conflicts of interest that are directly relevant to the content of this study.
Members of the study group: Aramini Enrico, Augello Giuseppe, Balzan Corrado, Baraldini Laura, Benincasa Francesco, Beretta Enrico, Bertini Luigi, Bonfiglio Salvatore, Bosisio Marina, Camilleri Vincenzo, Caraceni Luciano, Caso Corrado, Cazzaniga Francesco, Collecchia Giampaolo, Colombo Ivo, Colombo Mario, Corasaniti Francesco, Corti Nearco, D’Anna Maria Achilla, Ermacora Tiziano, Fossati Bianca, Gambarelli Lino, Gentile Maurizio, Gerbino Francesco, Giglione Santo, Giordano Egidio, Iacovella Remo, La Vecchia Diego, Lippa Luciano, Longoni Paolo, Malavasi Paolo, Manganella Gerlanda, Marino Rosanna, Milano Maria, Mosconi Giulio, Mosconi Lidia, Nicolosi Mario, Paci Carmelo, Pennino Maria Immacolata, Perlot Mariapia, Pitruzzella Santo, Randi Daniela, Restivo Vetro Antonietta, Riva Maria Grazia, Saieva Stefania, Sancito Giuseppa, Scifo Giovanni, Suzzi Fabio, Talato Fabiola, Tonon Riccardo, Vento Giovanni, Vetro Filippo, Vinti Beniamino.
- 5.National Institute for Clinical Excellence. Technology Appraisal 27 Osteoarthritis and rheumatoid arthritis: COX II inhibitors: guidance. London: NICE, 2003Google Scholar
- 15.Russo P, Attanasio E, Baio G, et al. Una prima valutazione economica dell’impiego di rofecoxib versus FANS convenzionali nell’artrosi. Pharmacoeconomics 2001; 3(2): 81–9Google Scholar
- 17.Lucioni C, Chiroli S, Roggeri D, et al. Analisi di costo della terapia con celecoxib versus FANS tradizionali nell’atrosi in Italia. Pharmacoeconomics 2003; 5(1): 23–34Google Scholar
- 19.Harstall C, Ospina M. How prevalent is chronic pain? Pain: Clinical Updates 2003; 11(2): 1–4Google Scholar
- 22.Garattini L, Castelnuovo E, Lanzeni D, et al. Durata e costo delle visite in medicina generale: il progetto DYSCO. Farmacoeconomia e percorsi terapeutici 2003; 4(2): 109–14Google Scholar