The status of neuropathic pain in Europe
Apart from the high extremity of neuropathic pain (NP), one of the pitfalls of this ill condition is the humanistic and economic burden. In this study, perception is based on this burden in countries- Germany, Spain, France, Italy and the UK with the emphasis laid on direct and indirect costs, productivity loss, and humanistic impact on patients and their families.
The data on NP patients engulfed the sick leave and retirement, drug treatments, demographics, number of consultations and surgical procedures which were presented on the physician questionnaires. The other questionnaires were the EuroQol 5-Dimension (EQ-5D), Productivity and Activity Impairment (WPAI) and the Brief Pain Inventory (BPI) questionnaires in which the demographic and disease-related data was mentioned by the patients. Wherever important, the health-related direct unitary costs were composed from relevant country-specific sources and adjusted to 2012 prices (€). The subgroup analysis of costs was addressed on fibromyalgia (n=300), low back pain (n=963) and diabetic peripheral neuropathy (n=894).
Almost 3,956 patient records forms were finished by 413 physicians. €1,939 (Italy) to €3,131 (Spain) was just the overall annual direct health-care cost per patient. Most of the care is rendered by the family and friends and only partial care by the annual professional caregiver whose costs varies from €393 (France) to €1,242 (UK). Almost 10%–32% patients are intercepted from working at some point by NP and the sick leave costs range from €5,492 (UK) to €7,098 (France). The aggregate 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%). The indirect costs consisted 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. The integral annual direct costs per patient were lofty for neuropathic back pain and radiculopathy, and lowest for fibromyalgia as per the subgroup assessment. The 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 end products urge that a notable proportion of the patient's work time in the previous week was influenced by NP and these are relatively high compared with other diseases like diabetes, respiratory conditions and arthritis.
As per the verdict, a high opportunity cost for society in terms of lost work and productivity due to NP is obtained notwithstanding differences in practice between countries. Extensively, the costs appear significantly higher to patients, carers/families and society as a whole than to the health system alone.