The application of economic evaluation methods in the chronic pain medicine literature.
BACKGROUND
The relative efficiency of a health care intervention or health status improvement realized for a given amount of resources expended can be determined using cost-effectiveness analysis or cost-utility analysis.


METHODS
An extensive chronic pain-focused search was undertaken of the MEDLINE, EMBASE, and SCI-EXPANDED databases. A total of 1822 unique citations were generated, with 142 studies subsequently categorized as incorporating one of seven recognized types of health care economic evaluation.


RESULTS
Of the 142 identified chronic pain-related economic evaluations published between 1988 and 2006, 30 incorporated a cost-effectiveness analysis and 29 incorporated a cost-utility analysis. The data are consistent with the previously reported chronological pattern of an increased overall diffusion of cost-utility analysis studies from the general medical and health services research literature into the medical subspecialty journals. However, only a few studies combined the economic analysis alongside a randomized controlled trial, the economic end-points in the trials had limited time horizons, and there was failure to address the protracted costs versus benefits of treating long-term and often recurrent chronic pain conditions.


CONCLUSIONS
Although it would appear worthwhile for researchers and clinicians to consider cost-effectiveness analysis and cost-utility analysis in their trial designs and treatment algorithms for chronic pain conditions, methodological improvements can be made in trial designs.
Vetter
Thomas R
TR
Department of Anesthesia, Indiana University School of Medicine, Indianapolis, Indiana, USA. tvetter@iupui.edu
D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000191:economics; D010146:Pain / Q000191:economics* / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic / Q000191:economics / Q000379:methods