OBJECTIVE: Chronic non-cancer pain (CNCP) is a condition that may result in high healthcare costs and reduced workplace productivity. The objective of this study was to quantify work loss and pain-related healthcare utilization among employees with CNCP. METHODS: A retrospective analysis was conducted using the MEDSTAT Health and Productivity Management database, which includes absences, worker's compensation and short-term disability claims for employees from six large U.S. corporations along with inpatient, outpatient, and pharmacy claims from 1997-1999. Presence of CNCP was defined as 90+ days supply of opioids within the study period and a pain-related diagnosis. Workdays lost (absences plus short-term disability) were converted to dollars ($US1998) using location-specific wage rates from the US Bureau of Labor Statistics. Healthcare utilization included opioid usage, pain-related outpatient medical visits, and pain-related inpatient hospitalizations. RESULTS: From the original outpatient data file of 236,736 employees, 2,459 had CNCP and were eligible to have work loss data reported, of which 1,512 experienced sickness absence(s) and/or short-term disability days. Those with work loss experienced a longer median duration of pain than those without work loss (887 vs. 934.5 days). Pain-related direct costs were $5378 per employee per year. Indirect costs (wages lost per employee per year) were $5339-$7475, based on sensitivity analyses. The total impact of CNCP for employees whose work loss was recorded was at least $2.1 million per employer per year. CONCLUSIONS: Few data have been compiled to examine the economic impact of CNCP specifically to employers. The findings demonstrate that CNCP is associated with significant resource consumption and lost workdays, and suggest a need for employer-sponsored pain management programs.