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. 2024 May 1;40(5):306-319.
doi: 10.1097/AJP.0000000000001199.

Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents With Chronic Pain: A Systematic Review

Anne Kitschen  1 , Diana Wahidie  2 , Dorothee Meyer  3   4 , Lisa-Marie Rau  3   5 , Ann-Kristin Ruhe  3   5 , Julia Wager  3   4   5 , Boris Zernikow  3   4   5 , Dirk Sauerland  1
Affiliations

Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents With Chronic Pain: A Systematic Review

Anne Kitschen et al. Clin J 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, health care payers, and society. Therefore, this systematic review aimed 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 2 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. The mean annual direct costs of CPCA ranged from PPP-USD 603 to PPP-USD 16,271, with outpatient services accounting for the largest share. The mean annual indirect costs ranged from PPP-USD 92 to PPP-USD 12,721. All EEs reported a decrease in overall costs in treated patients.

Discussion: The methodology across studies was heterogeneous limiting the comparability. However, it is concluded 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 specialized pain treatment.

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Conflict of interest statement

This work is funded by the Innovation Fund of the Joint Federal Committee (Gemeinsamer Bundesausschuss, G-BA, 01VSF20008) Berlin, Germany. The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart. The figure shows the process of the systematic literature search with the databases used and reasons for excluding studies. HTA indicates Health Technology Assessment Database; NHS EED, National Institute for Health Research Economic Evaluation Database.
See this image and copyright information in PMC

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