An analysis of a claims database comparing patients with neuropathy to those with diabetes provided a similar estimate of the diabetes-specific incremental cost of medical care (in 2003 dollars). Regression-adjusted mean annual cost of diabetes care of $5,125 among those with DPN compared with $1,297 for those with diabetes but without neuropathy or depression. Neuropathy patients also had higher rates of comorbidities, and greatly elevated all-cause healthcare costs. Those with neuropathy had approximately $25,000 in annual all-cause medical costs compared to approximately $5,000 for those with diabetes, with significantly higher costs in all types of care, including inpatient, outpatient, ER, and pharmacy costs [8]. Another study comparing DPN patients with depression and/or anxiety versus those without depression and anxiety across multiple claims databases found all-cause healthcare costs of approximately $22,000 per patient per year, with approximately $3,000 worth of diabetes-specific care (2006 US$).¹ [9] The lower costs reported in this study are partially due to the inclusion of patients with Medicare supplemental insurance. Limiting analyses to commercially-insured patients would raise the diabetes-related and all-cause healthcare costs to approximately $3,900 and $24,900 per patient per year, respectively.

Much of the recent literature has focused on the costs associated with pDPN. Healthcare resource use is clearly elevated among those with DPN [10], and increased use begets increased costs. Several studies have compared costs between patients receiving different treatments for DPN pain. Though these comparisons are outside the scope of this review, the medical costs incurred by these patients are even higher than those reported for DPN in general. Those newly prescribed pregabalin or gabapentin for pDPN incurred approximately $32,000 worth of direct medical costs in the year following the index date [11]. A similar analysis comparing medical costs among those prescribed pregabalin or duloxetine found similar mean costs of approximately $31,000 in the year following the index date [12]. Likewise, the overall mean direct costs incurred by patients aged 18–64 with pDPN treated with either duloxetine or standard of care was approximately $31,000 [13].