Healthcare Utilization in People with Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy

OBJECTIVES: To determine and compare healthcare utilization and costs for younger and older adults with postherpetic neuralgia (PHN) and painful diabetic peripheral neuropathy (DPN). DESIGN: Retrospective cohort analysis. SETTING: Inpatient and outpatient care. PARTICIPANTS: Patients with PHN or painful DPN were selected from administrative databases of healthcare claims and matched to controls who had a diagnosis of herpes zoster without persistent pain or a diagnosis of diabetes mellitus without neurological complications using propensity scores for demographic and clinical factors. MEASUREMENTS: Excess per-person utilization and costs attributable to PHN and painful DPN were calculated for diagnostic procedures, medications, and interventional treatments related to neuropathic pain. RESULTS: In both groups, the patterns of significant excess per-patient utilization and excess per-patient costs were similar for diagnostic procedures, medications, and interventional treatments, but patterns of utilization and costs of these procedures and treatments differed depending on age and the specific condition examined. CONCLUSION: The results contribute to and expand current knowledge of the excess healthcare usage and costs of two prevalent peripheral neuropathic pain conditions and can be used in future studies of the cost-effectiveness of treatment and preventive interventions. J Am Geriatr Soc 59:827-836, 2011.