(285) Costs and utilization of pharmacologic interventions for fibromyalgia and its comorbidities

Abstract

Fibromyalgia (FM) is a condition characterized by patient self-report of widespread pain. The prevalence of FM is estimated to be 2.0% in the general population and 3.4% among women. The purpose of this study was to contrast the diagnosed prevalence of co-occurring disease states between a cohort of fibromyalgia patients and a matched control group and to further evaluate the utilization and costs associated with pharmacologic interventions for fibromyalgia and its comorbidities. The sample consisted of persons over age 18 identified in the Marketscan databases from 2001-2003. Patients with fibromyalgia (ICD9 code 729.1) were matched to a control cohort using demographic variables and the time of first clinical event. The prevalence of other diagnosed disorders, utilization and cost information came from claims databases. The study sample consisted of 35,340 fibromyalgia patients and 220,732 controls. Fibromyalgia patients had a mean age of 47.9 (sd 9.9), and were mostly female (80%). Relative to controls, fibromyalgia patients were more likely to be diagnosed with musculoskeletal disorders (74.5% vs 34.4%), peripheral neuropathic pain conditions (10.8% vs 3.2%), bowel and bladder disorders (5.1% vs 1.4%), headaches (17.6% vs 6.0%), fatigue (18.8% vs 7.3%), sleep disorders (8.1% vs 2.4%), depression (15.6% vs 5.4%), and anxiety (6.9% vs 2.8%) (all comparisons p < .001). Medication use was greater in six different therapeutic classes examined: analgesics (74.5% vs. 40.0%), antidepressants (56.1% vs. 19.0%), anxiolytics (27.4% vs 10.6%), insomnia drugs (18.6% vs. 4.3%), anticonvulsants (23.9% vs. 4.1%) and muscle relaxants (40.4% vs 8.4%). Total 12-month expenditures for prescription medications among fibromyalgia patients with use were $3,034.15 compared to $1,177.82 among controls with use (p < .001). Higher utilization of pharmacologic interventions for fibromyalgia and its comorbidities results in significantly greater direct medical care expenditures among these patients and suggests the need for new interventions. Supported by Pfizer, Inc.