Issues in the economic analysis of therapies for cancer pain

Economic analysis of cancer pain management is hampered by the lack of systematic outcomes research. There is some consensus on the broad structures that should be in place to provide optimal care, but the relative costs and benefits of the many analgesic interventions are not known. Clinical decision making in individual cases, like the consensus itself, is guided mainly by experience and anecdote. Meaningful economic analyses based on empirical information about cost and a range of subjective and objective outcomes are needed to minimize cost without compromising care. At present, potential problems in the reimbursement system that may be increasing the cost of pain management or compromising the quality of this care can be identified, and efforts are needed to address these problems.