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Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.

Publication ,  Journal Article
Elsamadicy, AA; Yang, S; Sergesketter, AR; Ashraf, B; Charalambous, L; Kemeny, H; Ejikeme, T; Ren, X; Pagadala, P; Parente, B; Xie, J; Lad, SP
Published in: Neuromodulation
July 2018

OBJECTIVE: The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. MATERIALS AND METHODS: A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012. We collected total, outpatient, and pain prescription costs three years prior to CRPS diagnosis (baseline), at year of CRPS diagnosis, and eight-year post-CRPS diagnosis. A longitudinal multivariate analysis was used to model the estimated total and pain prescription cost ratios comparing patients diagnosed before and after CRPS. RESULTS: We included 35,316 patients with a newly indexed diagnosis of CRPS (Type I: n = 18,703, Type II: n = 14,599, Unspecified: n = 2014). Baseline characteristics were similar between the CRPS cohorts. Compared to two- and three-year baseline costs, one-year prior to diagnosis for all CRPS patients yielded the highest interquartile median [IQR] costs: total costs $7904[$3469, $16,084]; outpatient costs $6706[$3119, $12,715]; and pain prescription costs $1862[$147, $7649]. At the year of CRPS diagnosis, the median [IQR] costs were significantly higher than baseline costs: total costs $8508[$3943, $16,666]; outpatient costs $7251[$3527, $13,568]; and pain prescription costs $2077[$140, $8856]. Over the eight-year period after CRPS diagnosis, costs between all the years were similar, ranging from the highest (one-year) to lowest (seven-years), $4845 to $3888. The median total cumulative cost 8-years after CRPS diagnosis was $43,026 and $12,037 for pain prescription costs. [Correction added on 06 November 2017 after first online publication: the preceding sentence has been updated to demonstrate the median cumulative cost in replacement of the additive cumulative mean costs.]. During the CRPS diagnosis period, patients are expected to have a total cost 2.17-fold and prescription cost 2.56-fold of their baseline cost annually. CONCLUSIONS: Our study demonstrates that there is a significant increase in cost and healthcare resource utilization one-year prior to and around the time of CRPS diagnosis. Furthermore, there is an increased annual cost post-diagnosis compared to baseline costs prior to CRPS diagnosis.

Duke Scholars

Published In

Neuromodulation

DOI

EISSN

1525-1403

Publication Date

July 2018

Volume

21

Issue

5

Start / End Page

423 / 430

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Regression Analysis
  • Prevalence
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Humans
 

Citation

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ICMJE
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Elsamadicy, A. A., Yang, S., Sergesketter, A. R., Ashraf, B., Charalambous, L., Kemeny, H., … Lad, S. P. (2018). Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation. Neuromodulation, 21(5), 423–430. https://doi.org/10.1111/ner.12691
Elsamadicy, Aladine A., Siyun Yang, Amanda R. Sergesketter, Bilal Ashraf, Lefko Charalambous, Hanna Kemeny, Tiffany Ejikeme, et al. “Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.Neuromodulation 21, no. 5 (July 2018): 423–30. https://doi.org/10.1111/ner.12691.
Elsamadicy AA, Yang S, Sergesketter AR, Ashraf B, Charalambous L, Kemeny H, et al. Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation. Neuromodulation. 2018 Jul;21(5):423–30.
Elsamadicy, Aladine A., et al. “Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.Neuromodulation, vol. 21, no. 5, July 2018, pp. 423–30. Pubmed, doi:10.1111/ner.12691.
Elsamadicy AA, Yang S, Sergesketter AR, Ashraf B, Charalambous L, Kemeny H, Ejikeme T, Ren X, Pagadala P, Parente B, Xie J, Lad SP. Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation. Neuromodulation. 2018 Jul;21(5):423–430.
Journal cover image

Published In

Neuromodulation

DOI

EISSN

1525-1403

Publication Date

July 2018

Volume

21

Issue

5

Start / End Page

423 / 430

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Regression Analysis
  • Prevalence
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Humans