OBJECTIVES: To estimate the annual aggregate expenditures of prescription pharmaceuticals in the treatment of peripheral neuropathic pain in the United States over a seven year period. METHODS: We utilized annually compiled data for the years 2005-2011 of the Medical Expenditure Panel Survey (MEPS), a publically available dataset to construct cross-sectional, representative estimates of medical expenses and utilization for the civilian, non-institutionalized US population.  We  identified cases using International Classification of Disease-Ninth Revision, Clinical Modification (ICD-9-CM) codes which denoted conditions prone to peripheral neuropathy (diabetes mellitus and herpes zoster), or indicated peripheral neuropathy directly.  These were associated with pharmacy records using Cerner Multum™ classifications for classes of medication commonly used for treating neuropathic pain.   Prescriptions counts and costs were aggregated by year.  Survey weighting, clustering and stratification variables were used to give unbiased national estimates of prescription utilization and expenditures.  All costs were inflated to 2011 dollars using the medical Consumer Price Index.    RESULTS: A total of 2782 survey respondents had at least one prescribed medicine associated with treatment of a neuropathic pain diagnosis, representing 2.9 million persons in 2005 and increasing to 3.9 million in 2011 (annual increase of 3.1%, p=0.05).   Both total prescriptions and total expenditures peaked in 2008 ($1.1 billion(b) and 20.3 million (m) prescriptions, respectively) , then declined through 2011.  Narcotic analgesics and gabapentinoids were the drug classes with the largest mean annual expenditures ($305m and $211m) , followed by serotonin-noradrenalin reuptake inhibitors ($141m).  Non-gabapentinoid anticonvulsants, tricyclic antidepressants, and topical analgesics had substantial declines in usage and expenditures from 2005 to 2011.   Non-narcotic analgesics utilization and expenses, including NSAIDs and tramadol, remained largely stable during the study period. CONCLUSIONS: Prescription medications for peripheral neuropathic pain treatment experienced large swings in usage and expenditures from 2005-2011, peaking in 2008 despite steady increases in the number of neuropathic pain medication users.