title: Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain.
abstract: Chronic pain is one of the most prevalent and costly problems in the United States today. Traditional medical treatments for it, though, have not been consistently efficacious or cost-effective. In contrast, more recent comprehensive pain programs (CPPs) have been shown to be both therapeutically efficacious and cost-effective. The present study reviews available evidence demonstrating the therapeutic efficacy and cost-effectiveness of CPPs, relative to conventional medical treatment. Searches of the chronic pain treatment literature during the past decade were conducted for this purpose, using MEDLINE and PSYCHLIT. Studies reporting treatment outcome results for patients with chronic pain were selected, and data on the major outcome variables of self-reported pain, function, healthcare utilization and cost, medication use, work factors, and insurance claims were evaluated. When available, conventional medical treatments were used as the benchmark against which CPPs were evaluated. This review clearly demonstrates that CPPs offer the most efficacious and cost-effective, evidence-based treatment for persons with chronic pain. Unfortunately, such programs are not being taken advantage of because of short-sighted cost-containment policies of third-party payers.
  
  
  CONCLUSIONS
  A comprehensive review was conducted of all studies in the scientific literature reporting treatment outcomes for patients with chronic pain. This review clearly revealed that CPPs offer the most efficacious and cost-effective treatment for persons with chronic pain, relative to a host of widely used conventional medical treatment.
authors.affiliation: Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, Texas, USA. Robert.gatchel@utsouthwestern.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gatchel
authors.forename: Akiko
authors.initials: A
authors.lastname: Okifuji
mesh_terms: D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000191:economics* / Q000534:rehabilitation; D059408:Pain Management; D011788:Quality of Life