Back to Journals » ClinicoEconomics and Outcomes Research » Volume 8

A burden of illness study for neuropathic pain in Europe

Authors Liedgens H, Obradovic M, De Courcy J, Holbrook T, Jakubanis R

Received 22 January 2015

Accepted for publication 3 January 2016

Published 27 April 2016 Volume 2016:8 Pages 113—126


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Hiltrud Liedgens,1 Marko Obradovic,1 Jonathan De Courcy,2 Timothy Holbrook,2 Rafal Jakubanis2

1Grunenthal, Aachen, Germany; 2Adelphi Real World, Bollington, Cheshire, UK

Purpose: Neuropathic pain (NP) is often severe and represents a major humanistic and economic burden. This study aimed at providing insight on this burden across France, Germany, Italy, Spain, and the UK, considering direct and indirect costs, productivity loss, and humanistic impact on patients and their families.
Methods: Physician questionnaires provided data on patients presenting with NP covering demographics, sick leave and retirement, number of consultations, drug treatments, and surgical procedures. Patients provided further demographic and disease-related data and completed the Work Productivity and Activity Impairment (WPAI), the EuroQol 5-Dimension (EQ-5D), and the Brief Pain Inventory (BPI) questionnaires. All health-related direct unitary costs were collected from relevant country-specific sources and adjusted to 2012 prices (€) where necessary. A subgroup analysis of costs based on diabetic peripheral neuropathy (n=894), fibromyalgia (n=300), and low back pain (n=963) was performed.
Findings: About 413 physicians completed a total of 3,956 patient records forms. Total annual direct health-care costs per patient ranged from €1,939 (Italy) to €3,131 (Spain). Annual professional caregiver costs ranged from €393 (France) to €1,242 (UK), but this only represented a small proportion of total care because much care is provided by family or friends. Sick leave costs ranged from €5,492 (UK) to €7,098 (France), with 10%–32% patients prevented from working at some point by NP. Total cost (including direct and indirect costs) of NP per patient was €10,313 in France (69% of the total cost), €14,446 in Germany (78%), €9,305 in Italy (69%), €10,597 in Spain (67%), and €9,685 in the UK (57%). Indirect costs (ie, sick leave) constituted the majority of costs in all five countries: €7,098 in France, €11,232 in Germany, €6,382 in Italy, €7,066 in Spain, and €5,492 in the UK. In the subgroup analysis, total annual direct costs per patient were highest for neuropathic back pain and radiculopathy, and lowest for fibromyalgia. Mean WPAI score range was 34.4–56.1; BPI interference was 4.1–4.8; and EQ-5D was 0.57–0.74. The results suggest that a significant proportion of the patient's work time in the previous week was affected by NP, and these are relatively high compared with other diseases such as diabetes, respiratory conditions, and arthritis.
Implications: Despite differences in practice between countries, these findings suggest a high opportunity cost for society in terms of lost work and productivity due to NP. The wider costs appear significantly higher to patients, carers/families, and society as a whole than to the health system alone.

neuropathic pain, burden of illness, chronic lower back pain, productivity

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Readers of this article also read:

Patient involvement in clinical research: why, when, and how

Sacristán JA, Aguarón A, Avendaño-Solá C, Garrido P, Carrión J, Gutiérrez A, Kroes R, Flores A

Patient Preference and Adherence 2016, 10:631-640

Published Date: 27 April 2016

Perioperative management of hemophilia patients receiving total hip and knee arthroplasty: a complication report of two cases

Tateiwa T, Takahashi Y, Ishida T, Kubo K, Masaoka T, Shishido T, Sano K, Yamamoto K

Therapeutics and Clinical Risk Management 2015, 11:1383-1389

Published Date: 15 September 2015

A new recombinant factor VIII: from genetics to clinical use

Santagostino E

Drug Design, Development and Therapy 2014, 8:2507-2515

Published Date: 12 December 2014

Managing hemophilia: the role of mobile technology

Khair K, Holland M

Smart Homecare Technology and TeleHealth 2014, 2:39-44

Published Date: 6 May 2014

Two cases of mild serotonin toxicity via 5-hydroxytryptamine 1A receptor stimulation

Nakayama H, Umeda S, Nibuya M, Terao T, Nisijima K, Nomura S

Neuropsychiatric Disease and Treatment 2014, 10:283-287

Published Date: 11 February 2014