Introduction: Chronic pain is both a prevalent and costly problem in our society. Pain rehabilitation programs have been shown to be cost-effective treatments for chronic non-malignant pain (CNMP). A treatment goal for some rehabilitation programs is the reduction in the use of pain-related medication. Medication costs represent a relatively small but significant portion of the cost of chronic pain. Medication costs changes following pain rehabilitation programs have not been analyzed in previous studies.

Methods: This prospective cohort study of 177 patients addresses the cost of medication to patients with CNMP at admission to a 3 week outpatient pain rehabilitation program, at completion, and at 6 month follow-up. Average wholesale price (AWP) was used to determine the medication cost. All patients were interviewed by a pharmacist at admission and dismissal to determine actual daily medication use. Patients were recruited for enrollment at admission to the rehabilitation program and Institutional Review Board approval was obtained for this study.

Results: From the original study cohort, 112 patients (63%) completed a 6 month follow-up survey. The mean (SD) daily medication cost on admission to the program was $23.66 ($17.25). Statistically significant medication cost savings were seen at dismissal and at 6 month follow-up (p<0.05). The mean (SD) daily prescription medication cost savings from admission to dismissal was $8.63 ($12.00). The mean daily prescription medication cost savings from admission to 6 month follow-up was $7.77 ($14.86). Both time points represent more than a 30% reduction in medication costs. Daily medication costs did not include over-the-counter, topical, parenteral, inhalation, ophthalmic, and intrathecal medications.

Conclusions: Patients benefited from significant medication cost savings at the completion of the 3 week outpatient pain rehabilitation program and maintained significant savings after 6 months. This study adds to the current literature on the economic value of comprehensive pain programs.