OBJECTIVES: To evaluate the health care and productivity costs in chronic low back pain (CLBP) patients with a probable neuropathic pain (NeP) component before and after the initiation of pregabalin, gabapentin or a TCA (tricycle antidepressant). METHODS: Patients with primary diagnosis of CLBP (ICD-10: M43, M45-48, M50-51, M53-54) and at least two prescription claims for either pregabalin, gabapentin or a TCA were identified using data from the National Patient Registry, the Medicinal Registry, and other registries (2004-2010). Patients identified with generalized anxiety disorders or seizures were excluded. The index date was considered the first prescription for pregabalin, gabapentin or a TCA. Descriptive assessments of healthcare and productivity costs were conducted 12 months pre and 12 months post the index date using the full dataset. To control for selection bias, a propensity score matched cohort controlling for age, gender, socioeconomic status, education, depression, and health care resource use was also conducted. Statistical tests performed were Wilcoxon (α=0.05). RESULTS: A total of 6,028 of 7,282 CLBP patients with NeP met the inclusion criteria (treatment courses included: 3,507 TCA; 2,735 gabapentin; 1,293 pregabalin). Twelve months health care costs increased significantly in all 3 groups (€377 - €1,113) (P<0.001). Matched sub-analyses covering 1,217 patients in each group showed similar significant healthcare cost increases; however, the pregabalin group was the only group to result in a significant reduction in hospitalization costs (P=0.03). Across all three groups number of job losses was reduced, whereas long-term sickness increased; however, insignificantly so in the pregabalin group. CONCLUSIONS: This study showed increasing healthc are costs 12 months after the initiation of NeP drug treatment in CBLP patients with NeP. In matched analyses the increased health care costs in the pregabalin group were partly offset by significant savings in hospitalization costs. Production lost increased in all three groups; however, only significant in the TCA and gabapentin groups.