OBJECTIVES: Peripheral neuropathic pain (PNP) implies a significant economic burden that results in major health care and indirect costs. The aim of the present analysis was modelling the association and predictive value of pain intensity on costs and resources utilization (healthcare and non-health resources) in patients with chronic PNP treated in routine clinical practice conditions in Spain.                                                   METHODS: Secondary economic analysis based on data from a multicenter, observational and prospective cost-of-illness study in patients with chronic PNP refractory to previous treatment. Data on resources utilization and pain intensity was collected at baseline and 12 weeks after starting a new treatment. Pain intensity was measured using the 0-100 mm Visual Analogue Scale (VAS) of the Short Form McGill Pain Questionnaire. Univariate and multivariate linear regression models were fitted to identify independent predictors of costs and healthcare and non-health care resources utilization. RESULTS: A total of 1703 patients were included in the current analysis. Pain intensity was an independent predictor of total costs ([Total costs(Euros)] = 35.6 x [VAS pain intensity] + 214.5; coefficient of determination [R2]=0.19, p<0.001), direct costs ([Direct costs(Euros)] = 10.8 x [VAS pain intensity] + 257.7; R2=0.06, p<0.001) and indirect costs ([Indirect costs(Euros)] = 24.8 x [VAS pain intensity] – 43.4; R2=0.19, p<0.001) related to chronic PNP in the univariate analysis. Pain intensity remain significantly associated with total costs, direct costs and indirect costs after adjustment by other covariates in the multivariate analysis (p<0.001). The impact of pain intensity on healthcare and non-healthcare resources utilization accounted for such findings. CONCLUSIONS: Pain intensity predicts the healthcare and non-healthcare resources utilization, and costs related to chronic PNP. Management of patients with drugs associated with a higher reduction of pain intensity will have a greater impact on the economic burden of that condition.