Living With Chronic Pain

The Financial Impact Of Chronic Pain

Chronic pain is expensive. From personal experience, I know this is true. The costs of evaluations, scans, provider visits, injections, medications. . . it just never seems to end. Especially in this day of exorbitant deductibles and co- pays.

As a physician and chronic pain sufferer, I’m struck by the lack of attention and coverage that exists for the expense of non-pharmacological treatment, especially in light of the opioid issue. I enthusiastically promote alternatives such as acupuncture, appropriate exercise programs, biofeedback, massage, compounded topical creams, TENS units (Transcutaneous electrical nerve stimulation- I’ll discuss these in a future post), physical therapy, and other options. Yet, many of these treatments are not covered by most insurance plans and can be very expensive to pay for out of pocket.

I love lidoderm patches – a topical numbing patch that’s benign to use 12 hours a day. I was shocked to learn the already expensive cost of $75 per month on one insurance plan was actually $700 dollars for the exact same item on another plan. That’s insane!  In the case of something like massage, physical therapy or acupuncture, it can cost well over $100 per visit. Since these therapies usually require multiple visits to achieve long-term outcomes, it can cost patients hundreds or thousands of dollars to cover the costs of such treatments. Considering that most people with disability live below the poverty level, many people with chronic pain may not be in a financial position to fund these alternative treatments, meaning they are basically unavailable to them. Yet opioids are covered in a heartbeat! 

Americans spend as much as $635 billion each year on the direct and indirect costs associated with chronic pain, according to a study. 

That’s more than the annual costs associated with cancer, heart disease, and diabetes, said study authors Darrell Gaskin and Patrick Richard, health economists at Johns Hopkins University. They based their estimate on health care costs and lost worker productivity associated with chronic pain.

The researchers analyzed the 2008 Medical Expenditure Panel Survey to measure the incremental health care costs for people affected by chronic pain – including pain that interferes with work, joint pain, arthritis and disabilities – and compared them to costs for people without chronic pain. The study involved more than 20,200 U.S. adults. 

The costs of certain conditions were calculated for a variety of payers of health care services, the researchers noted.

The study, published in the Journal of Pain, found average health care costs for adults were $4,475. People suffering from moderate pain paid $4,516 more in health care costs than those without pain, the researchers said. Patients with severe pain spent $3,210 more than people with only moderate pain. Costs were also $4,048 higher for those with joint pain, $5,838 higher for people with arthritis and $9,680 more for those with functional disabilities.

When prevalence of pain conditions was assessed, moderate pain accounted for 10 percent, severe pain accounted for 11 percent and disability represented 12 percent. Estimates for joint pain and arthritis were higher. They accounted for 33 percent and 25 percent of prevalence estimates, respectively.

The researchers also noted that adults affected by chronic pain missed more workdays than people without pain. This affected their annual hours worked and hourly wages. The study concluded the total cost associated with pain in the United States was at least $560 billion and possibly as high as $635 billion, according to a release from the American Pain Society.

Broken down, the total incremental costs of health care resulting from chronic pain ranged from $261 billion to $300 billion. And the costs associated with lost productivity ranged from $299 billion to $334 billion. Although the per-person cost of pain is less than the cost of other diseases, the researchers said the total cost of chronic pain is higher. They said the costs associated with chronic pain would be even greater if they took into account nursing home residents, military personnel, prisoners, children and caregivers.

Chronic pain impacts everyone- family, friends, coworkers, and companies, not just those who suffer with it everyday. It’s about time we came up with better ways to diminish its impact. From letting go of age-old misconceptions like it just affects those “with low pain thresholds”  or “drug seekers,” pain is debilitating. We need to be offering wider, more appropriate, effective treatment options that can improve outcomes and decease costs. I’ve always believed the goal should be helping patients to live with chronic pain. 

Anyone who advertises eradicating the pain is preying on our desire and hope it’s possible, but know it can’t be true. No one can make my spine the way it was before dozens of surgeries. The reality- I need to learn ways to adapt and cope so I can enjoy life and all it has to offer. That’s why changing how we deal with chronic pain is so important. In conjunction with medications, the opportunity to sit down one on one and have a discussion of lifestyle changes, in many cases weight loss, specific examples of individualized exercises, family dynamics, and alternative options, needs to be better addressed. These issues are impossible to attend to in a quick visit. My fervent hope is that insurance plans and providers will finally give patients the intervention they deserve.


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