Background and Objective: Chronic pain is a highly prevalent problem, involving high
costs and seriously affecting a patient's quality of life. This review aimed to systematically review economic
evaluations of pharmacological-based treatments for non-malignant chronic pain and to compare
different treatment approaches with regard to their economic profile.
Methods: PubMed and Scopus were systematically searched in April 2016. Studies were included if
quality-adjusted life years and incremental cost-effectiveness ratios were reported. Quality assessment
was carried out by using La Torre’s weighted scale on the Drummond checklist. Costs were converted
Results: Fourteen economic evaluations met the inclusion criteria. Three treatment categories identified
were: opioids, anticonvulsants, and anti-depressants. Compared to anticonvulsants and antidepressant,
opioids had lower ICER. Transdermal buprenorphine showed an ICER of about
US$11,000.00 while pregabalin showed an ICER of US$19,200. Studies included showed a diversity
of methodological approaches, such as different modeling approaches and different perspectives (NHS
and private payer).
Conclusion: There are limitations to the success of making appropriate recommendations about which
treatment is most cost-effective due to considerable variability between treatments, pain syndromes,
and drug dosages. Opioids may have lower ICER, but the societal implications of the opioid epidemic
and overdose deaths should be taken into account when coming to general conclusions about their
cost-effectiveness. To ensure correct resource allocation as well as the best benefit for patients, uniform
and standardized approaches of cost and outcome measurement in economic evaluations of
chronic are needed.