A new study shows that sickle cell pain management in a dedicated pain clinic is more cost-effective and timely than in an emergency setting. Patients seen in the pain clinic had no admissions, which the researchers noted confers clinical and economic benefits.
“Acute pain is the most common reason for healthcare utilization among adults living with sickle cell disease (SCD),” wrote the authors, led by Daniel Sop of Virginia Commonwealth University in Richmond. “While emergency departments (EDs) remain the default care setting for many SCD patients in pain, ED use is often associated with prolonged wait times, high likelihood of admission, and high costs, along with significant patient distress and delayed effective treatment.”
Some previous studies have suggested that SCD clinics provide better outcomes than ED settings due to an efficient yet more patient-centered approach. The current researchers sought to explore that concept at their large academic medical center, focusing on healthcare charges, admissions, and time to first pain medication.
They retrospectively analyzed outcomes for 548 adult patients with SCD who presented with acute pain in 2024. There were three subgroups: patients who visited the ED only (n=189), patients who visited both the ED and the pain clinic (n=172), and patients who visited the pain clinic only (n=187).
They found that ED visits were significantly more expensive and were associated with longer time to first administration of pain medications than visits to the pain clinic. Admission rates were 35.3% for those using the ED exclusively, 39.6% for those using both settings, and 0% for those using the pain clinic exclusively. Using modeling, the researchers estimated that about $25 million could have been saved if patients using both settings had used only the pain clinic, and an additional $13.7 million could have been saved if ED-only visitors had used the pain clinic exclusively instead.
“These findings reinforce the urgent need to expand access to outpatient infusion models and reduce dependency on the ED for acute pain crises in this high-utilization population,” the authors concluded.
Reference
Sop D, Zhang Y, Johnson S, et al. Comparative effectiveness of emergency department versus pain infusion clinic management for acute pain in adults with sickle cell disease: Implications for cost and timeliness of care. Abstract abs25-1772. Presented at: the 67th American Society of Hematology Annual Meeting and Exposition, Dec. 6-9, 2025, Orlando, FL.
