OBJECTIVES: To evaluate health care resource use, costs and patient-reported outcomes (PRO's) among patients with neuropathic pain, specifically for guideline-, non-guideline- and self-treatment-groups in Germany. METHODS: Patients were consecutively recruited by physicians in general practice (n=47) in 2005. Data on resource utilization due to neuropathic pain was collected retrospectively for six months. Costs were estimated from the societal perspective. PRO were assessed through generic SF-36 and disease-specific von Korff Index, and Patient Health Questionnaire Depression (PHQ-D) questionnaires at time of recruitment. Groups were compared using multivariable general linear modeling (GLM). RESULTS: Ninety-nine patients took part in this study (n=44 self-treatment, n=23 guideline, n=32 non-guideline-groups). The majority of patients were overweight, 61% of all patients were women, and 29% were currently employed.  Average duration of neuropathic pain was about 6.2 years and was comparable among the groups. Patients in the self-treatment-group were younger than patients in guideline or non-guideline-group (mean age 54.5 vs. 67.6 vs. 66.9 years, p<0.0001). Mean total costs per patient and 6 months were €674.23 [95%CI 225.95; 1122.51] vs. €1507.21 [95%CI 715.48; 2298.94] vs. €1426.24[95%CI 850.18; 2002.30] (self-treatment- vs. guideline vs. non-guideline-group, respectively, p=0.0092, by GLM adjusted by age and BMI). PRO as evaluated by von Korff Index and PHQ-D were better in the self-treatment-group patients. The groups did not differ in the mean component scores of SF-36. CONCLUSIONS: Patients in self-treatment-group in this study had the lowest societal mean total costs per patient and better PRO's (as evaluated by von Korff Index and PHQ-D) compared to other groups. No major differences were detected between guideline and non-guideline patients.