Research Article
EvaluationofTreatmentPatternsandDirectCostsAssociatedwith
the Management of Neuropathic Pain
Manuel E Machado-Duque ,
1,2
Andres Gaviria-Mendoza ,
1,2
Jorge E Machado-Alba ,
1
and Natalia Castaño
3
1
Grupo de Investigaci´ on en Farmacoepidemiolog´ ıa y Farmacovigilancia,
Universidad Tecnol´ ogica de Pereira-Audifarma S.A. Pereira, Pereira, Colombia
2
Grupo Biomedicina. Fundaci´ on Universitaria Aut´ onoma de Las Am´ ericas, Pereira, Colombia
3
Pfizer S.A.S, Bogot´ a, Colombia
Correspondence should be addressed to Jorge E Machado-Alba; machado@utp.edu.co
Received 26 December 2019; Revised 28 February 2020; Accepted 5 March 2020; Published 30 March 2020
Academic Editor: Giustino Varrassi
Copyright © 2020 Manuel E Machado-Duque et al. is is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain
are not fully described in different populations. e aim was to determine the treatment patterns and direct costs of care associated
with the management of neuropathic pain from the onset of the first symptom to up to two years after diagnosis. Methods.Froma
drug-claim database, a cohort of randomly selected outpatients diagnosed with neuropathic pain was obtained from an insurer in
Colombia and followed up for two years after diagnosis. e clinical records were reviewed individually to identify the study
variables, including the time needed to make the diagnosis, the medical and paraclinical resources used, the pharmacological
therapy for pain management, and the direct costs associated with care. Results.Weidentified624patientsin49cities,withamean
age of 50.3 ± 14.1 years, of which 324 were men (51.9%). An average of 90 days passed from the initial consultation until the
diagnosis of neuropathic pain, the most frequent being lumbosacral radiculopathy (57.9%). 34.5% of the cohort had at least one
diagnostic imaging procedure, and 16% had an electromyography. On average, they were treated by a general practitioner twice.
91.7% received initial treatment with tramadol, carbamazepine, amitriptyline, imipramine, or pregabalin, and 60.4% received
combined therapy. e mean cost of care for two years for each patient was US$246.3. Conclusions. Patients with neuropathic pain
in Colombia are being diagnosed late, are using therapeutic agents not recommended as first-line treatment by clinical practice
guidelines, and are being treated for short periods of time.
1. Introduction
Neuropathic pain has a prevalence of 2 to 17% in the general
population according to different studies [1]. e patholo-
gies that generally are accepted to cause neuropathic pain
include trigeminal neuralgia, painful diabetic poly-
neuropathy, and postherpetic neuralgia, among others [2].
Neuropathic pain is characterized by generation of intense
suffering for those who experience it and affects the quality
of life of these patients and their caregivers [3]. Neuropathic
pain is defined as pain produced by an injury or illness that
affects the somatosensory system [2–4].
Different therapeutic strategies are available to deal with
neuropathic pain, including both pharmacological and
nonpharmacological interventions [5, 6]. e pharmaco-
logical interventions recommended for neuropathic pain
management in clinical practice guidelines have been
classified according to their role in the etiology or underlying
pathophysiological mechanisms [3, 5, 7]. First-line treat-
ments include tricyclic antidepressants and anticonvulsants,
such as pregabalin and gabapentin, which have shown ef-
ficacy for pain management [3, 5, 7]. As second- and third-
line treatments, lidocaine, other antidepressants, especially
those with dual action, other anticonvulsants, and opioids,
Hindawi
Pain Research and Management
Volume 2020, Article ID 9353940, 8 pages
https://doi.org/10.1155/2020/9353940