Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents with Chronic Pain

Abstract

Objectives: Chronic pain in children and adolescents (CPCA) is widespread with an increasing prevalence. It is associated with a decreased quality of life and an increased parental work loss. Accordingly, CPCA may pose a substantial economic burden for patients, healthcare payers, and society. Therefore, this systematic review aims to synthesize (1) the results of existing cost-of-illness studies (COIs) for CPCA and (2) the evidence of economic evaluations (EEs) of interventions for CPCA. Methods: The systematic literature search was conducted in EMBASE, MEDLINE, PsycINFO, NHS EED, and HTA Database until February 2023. Title, abstract and full-text screening were conducted by two researchers. Original articles reporting costs related to CPCA published in English or German were included. Study characteristics, cost components, and costs were extracted. The quality of studies was assessed using standardized tools. All costs were adjusted to 2020 purchasing power parity US dollars (PPP-USD). Results: Fifteen COIs and 10 EEs were included. Mean annual direct costs of CPCA ranged from PPP-USD 603 to PPP-USD 16,271, with outpatient services accounting for the largest share. Mean annual indirect costs ranged from PPP-USD 92 to PPP-USD 12,721. All EEs reported a decrease of overall costs in treated patients. Discussion: The methodology across studies was heterogeneous limiting the comparability. However, it is to conclude that CPCA is associated with high overall costs, which were reduced in all EEs. From a health economic perspective, efforts should address the prevention and early detection of CPCA followed by a specialized pain treatment.