title: Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States.
abstract: OBJECTIVE
  To evaluate health care resource use, costs, and cost drivers among patients with neuropathic pain (NeP) after spinal cord injury (SCI) in a commercially insured population.
  
  
  METHODS
  Retrospective longitudinal cohort study comparing SCI patients with and without NeP.
  
  
  METHODS
  Truven Health MarketScan commercial claims database from 2005 through 2012.
  
  
  METHODS
  Commercially insured SCI patients with NeP (n=3524) propensity score matched to SCI patients without NeP (n=3524).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Health care resource utilization and expenditures for the 12 months after NeP onset (index event; identified through International Classification of Diseases, 9th Revision, Clinical Modification diagnosis 338.0x or use of NeP-specific antiepileptic drugs or NeP-specific antidepressants) in patients with SCI compared with matched patients without NeP.
  
  
  RESULTS
  Utilization over 12 months postindex among patients with SCI-associated NeP was higher than among SCI-only patients for inpatient admissions (27.4% vs 22.1%), emergency department visits (36.7% vs 26.4%), and office visits per patient (mean ± SD: 13.0±9.5 vs 9.5±8.3); all P values were <.001. All-cause expenditures showed adjusted incremental costs of $22,545 (95% confidence interval, $19,010-$26,168) per patient with SCI-associated NeP during the 12-month postindex period.
  
  
  CONCLUSIONS
  Patients with evidence of NeP secondary to SCI have significantly higher health care utilization and total costs compared with SCI patients without evidence of NeP. Factors contributing to NeP in patients with SCI need to be clinically assessed to determine the optimal approach for treating these individuals.
authors.affiliation: Truven Health Analytics, Bethesda, MD. Electronic address: jay.margolis@truvenhealth.com.
authors.forename: Jay M
authors.initials: JM
authors.lastname: Margolis
authors.affiliation: Truven Health Analytics, Bethesda, MD.
authors.forename: Paul
authors.initials: P
authors.lastname: Juneau
authors.affiliation: Pfizer Inc, New York, NY.
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.affiliation: Pfizer Inc, Groton, CT.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.affiliation: The Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Bryce
authors.affiliation: Rehabilitation Institute of Michigan, Detroit, MI.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Nieshoff
mesh_terms: D000293:Adolescent; D000328:Adult; D003132:Commerce; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000191:economics* / Q000209:etiology / Q000628:therapy; D009819:Office Visits / Q000706:statistics & numerical data; D059408:Pain Management / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000191:economics* / Q000628:therapy; D014481:United States; D055815:Young Adult
keywords: Burden of illness; Health expenditures; Neuropathic pain; Rehabilitation; Spinal cord injuries; Utilization