National SurveyThe survey findings demonstrate that MCOs are taking a wide range of approaches to managing chronic nonmalignant pain. Despite expressing concern about the cost of pain medications, however, relatively few of the survey respondents reported having an organized approach to chronic pain management already in place, and many did not see it as a high priority, independent of diagnosis-focused disease-management programs.

Although the survey response rate was only 25%, the respondents represented a good mix of plans by geographical region, plan size, and books of business. Results, therefore, may be cautiously generalized to the overall population of MCOs, although it is not known whether there are inherent differences for the nonresponding MCOs and their approaches to chronic pain management. In addition, although many respondents did not use the pre-coded response choices when answering the survey questions, these “other” responses could not be easily grouped into categories. This suggests that although plans might have a larger variety of management styles than is reflected here, the survey did capture many of the most common activities and beliefs. cialis professional 20 mg

The literature on chronic pain (see “Background” earlier) demonstrates that pain is highly prevalent, greatly decreases quality of life, and takes a significant economic toll on society. The survey results suggest that many MCOs are not yet actively engaged in the management of chronic pain despite the potential clinical, economic, and humanistic impact. However, this survey was descriptive in nature and did not seek to identify why more than half of the respondent MCOs identified pain management as a “low priority.” Possible explanations include:

• viewing other health problems as more important.
• seeing pain as a symptom rather than a manageable condition in its own right.
• not recognizing the prevalence or potential impact of pain in their member panels.
• believing that pain is already being managed appropriately.
• believing that pain management would not be effective or cost-effective.

Many respondents did comment that pain-management activities were now being developed within their organizations. canadian pharmacy


Future research should focus on understanding the current barriers to developing and implementing pain-management programs. Additional education of professionals in managed care regarding the impact of pain, along with supportive tools and programs to help MCOs achieve their pain-management objectives, might also be necessary. The survey suggests that many MCOs have incorporated pain-management activities, but few have developed systematic approaches to overall pain management. Again, research and education programs are needed to demonstrate the interconnectedness between formulary management and other aspects of effective pain management.