Economic aspects of pain therapy

Abstract

Economic aspects of pain therapy have been mainly investigated in acute postoperative pain. Increasing evidence suggests that, in this setting, sophisticated analgesic techniques (e.g. regional analgesia, patient-controlled analgesia, multimodal analgesia) offer results superior to conventional pain regimens. Increases of personnel costs together with recent cost reductions of patient-controlled analgesia pumps have made patient-controlled analgesia cost effective. In specific patient subgroups improved postoperative analgesia reduces complications and facilitates early discharge from post-anaesthesia care units, intensive care units and in some cases even the hospital. In chronic pain, few cost data are available. Inpatient therapy is more expensive than outpatient therapy but yields similar outcomes. The limited effectiveness of several invasive methods in pain therapy argue against their high cost. A thirty-fold range of costs has been shown for different opioids. There are few clear investigations of costs in relation to clinical outcome or pain relief.