The health care and productivity costs of back and neck pain in a multi-employer sample of utility industry employees.

Objective: To determine the cost of back and/or neck (B/N) pain among predominantly rural employees insured through an employee benefits trust.

Methods: Eligible employees had 1 year or more of medical coverage and completed a survey subsequently linked to their claims data. B/N pain costs consisted of medical and pharmacy claims, over-the-counter expenses, and presenteeism and absenteeism costs valued according to median occupational earnings.

Results: Of 1342 eligible employees, 52.7% currently had B/N pain of which 87.9% was chronic. The average annualized cost of B/N pain per employee was $1727; 56.1% was due to lost productivity. Covered medical care was utilized by 35.6% of employees, 55.7% used pharmacy care, and 71.6% purchased uncovered over-the-counter pain medication.

Conclusions: Many covered employees did not use formal care. The effect of care choices on productivity costs requires closer scrutiny.