Cost-Effectiveness of Medical Cannabis for Treatment of Chronic Pain: A Longitudinal Cohort Study of a Large German Hybrid Telemedicine Platform

OBJECTIVES: Cannabinoids may mitigate symptoms in chronic pain patients. Treatment costs are still considered higher than standard of care, with insurances in many countries rejecting cost reimbursement. We aimed to evaluate the effectiveness of medical cannabinoids for both health and economic aspects based on a retrospective analysis of a large cohort of patients treated with cannabinoids.

METHODS: We performed a quantitative longitudinal cohort study using anonymized data of chronic pain patients. Symptom severity indices were assessed using a 0-10 numeric rating scale. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist.

RESULTS: A total of 119 patients were included. Treatment with medical cannabis led to a significant improvement of symptom severity indices for pain (6.752 to 2.945), sleep (7.853 to 1.927) and appetite (4.580 to 1.077) compared to baseline. Quality-adjusted life year (QALY) improved significantly from 3.170 to 8.132. The average number of physician visits reduced significantly by 64.2%. Average annual medication cost was estimated to be €5,269.08 EUR. German willingness to pay (WTP) per 1-unit gain in QALY is €20,000.00 - €80,000.00 EUR. After applying a discount rate of 3%/year the average yearly WTP for the experienced overall improvement is €194,172.08 EUR.

CONCLUSIONS: Treatment with medical cannabis reduces symptom severity, improves quality of life, reduces overall health consumption, and is considered cost-effective compared to standard of care in chronic pain patients.