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Pain, facts and money Lieven Annemans Ghent University Lieven.Annemans@UGent.be Content 1. Some preliminary terminology 2. What we know about the burden of chronic pain 3. Something to think about Burden of

  1. Pain, facts and money Lieven Annemans Ghent University Lieven.Annemans@UGent.be ��������

  2. Content 1. Some preliminary terminology 2. What we know about the burden of chronic pain 3. Something to think about �

  3. Burden of Chronic pain � Economic Burden to the health care sector � Economic Burden to society (= incl. indirect costs related to absenteeism & presenteeism) � Health burden to patients (QoL, ADL) �

  4. “cost of illness” � Incidence based: � cost of a disease as from diagnosis until resolution of the problem or death � Prevalence based: � � � � cost per year for an average patient or for all patients together �

  5. Interpretation of cost 1. Cost to treat the disease or cost of care in patients with the disease? 2. Possible Study Perspectives ������� ������� ������ ����������� ���������� � �

  6. Content 1. Some preliminary terminology 2. What we know about the burden of chronic pain 3. Something to think about �

  7. 1. Medical cost is > 4 fold compared to matched controls ����������������������

  8. Management of chronic pain � Drugs � NSAIDS, analgesics, opioids, muscle relaxants, antidepressants, anti- epileptics, … � Different routes of administration � Physiotherapy (massage, electrotherapy, manual therapy, exercise programs, …) � Psychotherapy, CBT � Interventions (denervation, neurostimulation, neuromodulation,…) � Surgery (spinal fusion, …) � …. �

  9. Inadequate pain control �������������������� �

  10. Non adherence � more expensive ����������������������

  11. 2. Time related costs are much higher than direct medical costs ����������������������������������������������� ����������� 155; 5% 203; 7% 126; 4% public payer out of pocket private insurance lost time �� ��!���"#�$����#%���&��� &��'(��)�#�&������ *"&��#%��""����+�� ,)-.���"����#��/")�� 0����1�*"����"#��� 2627; 84% ������-�&�&�'"���+���� )"#�+&2 ��

  12. Switzerland Bachman 2009 ���������!��"#�$��������%��������������%�&��'�$��� %���������(�)������!�������* �+�� ����$���*����������$������� �����(�������� ��

  13. Absence from work �"��3���4�.#�)5�"���6���4���5"����+���5��#��#'�.�#*����)5�"�)�#� &���.&� ��������������������

  14. �2�7�*�"�&��&&"*������$��+�*"&�� �8.�������������������� ��

  15. Something to think about � The health insurance industry has continued to fail to take the needs of suffering chronic pain patients into consideration in developing and enacting their policies that ultimately dictate the quality and quantity of pain management services available to enrollees. (Schatman, US, 2011)

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