Treating patients with fibromyalgia in primary care settings under routine medical practice: a claim database cost and burden of illness study

Antoni Sicras,Milagrosa Blanca,Soledad Velasco,Carme Villarroya,Angela Morcillo,Ruth Navarro,Javier Rejas,Raquel Larios

doi:10.1186/ar2673

Antoni Sicras, Milagrosa Blanca + Show 6 more

Open Access

https://doi.org/10.1186/ar2673

Copy DOI

Abstract

IntroductionThe objective of this study was to analyze health care and non-health care resource utilization under routine medical practice in a primary care setting claims database and to estimate the incremental average cost per patient per year of fibromyalgia syndrome (FMS) compared with a reference population.MethodsA 12-month cross-sectional and retrospective study was completed using computerized medical records from a health provider database. Analyses were conducted from the perspective of the provider and from the viewpoint of society. Health care and non-health care resource utilization included drugs, complementary tests, all types of medical visits, referrals, hospitalizations, sick leave, and early retirement because of disability due to FMS. Patients with a diagnosis of FMS in accordance with ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th revision) criteria were included in the analysis if they had at least one claim for FMS during the 12 months prior to the end of May 2007. A non-FMS comparison group was also created with the remaining subjects.ResultsOf the 63,526 patients recruited for the study, 1,081 (1.7%) (96.7% of whom were women, 54.2 [10.1] years old) met the criteria for FMS. After an adjustment for age and gender, FMS subjects used significantly more health care resources than the reference population and had more sick leave and the percentage of subjects with premature retirement was also significantly higher (P < 0.001 in all cases). As a result, FMS subjects showed an incremental adjusted per-patient per-year total cost of €5,010 (95% confidence interval [CI] 3,494 to 6,076, +153%, P < 0.001) on average compared with non-FMS subjects. Significantly higher differences were observed in both health care and non-health care adjusted costs: €614 (404 to 823, +66%) and €4,394 (3,373 to 5,420, +189%), respectively (P < 0.001 in both cases). Annual drug expenditure per patient on average was considerably higher in FMS patients, €230 (124 to 335, +64%, P < 0.001), than the reference group.ConclusionsUnder routine medical practice, patients with FMS were associated with considerably higher annual total costs in the primary care setting compared with the reference population.

Highlights

The objective of this study was to analyze health care and non-health care resource utilization under routine medical practice in a primary care setting claims database and to estimate the incremental average cost per patient per year of fibromyalgia syndrome (FMS) compared with a reference population
Under routine medical practice, patients with FMS were associated with considerably higher annual total costs in the primary care setting compared with the reference population
The study population consisted of men and women from five renovated primary care (PC) centers (Apenins-Montigalà, Morera-Pomar, Montgat-Tiana, Nova Lloreda, and La Riera) that are managed by a health management organization (Badalona Serveis Assistencials S.A. [BSA], Barcelona, Spain) and that cover a population of 110,440 inhabitants, 16.5% of whom are over 64 years of age

Summary

Introduction

The objective of this study was to analyze health care and non-health care resource utilization under routine medical practice in a primary care setting claims database and to estimate the incremental average cost per patient per year of fibromyalgia syndrome (FMS) compared with a reference population. FMS is a widespread disorder of unknown etiology which affects an estimated 1% to 4% of the general population [4] It may occur in 2.1% to 5.7% of the general adult population, comprising 10% to 20% of rheumatologic consultations and 5% to 8% of primary care (PC) consultations and being the most frequent cause of general and chronic skeletal muscular pain [5,6,7]. The objective of this study was to analyze the use of health care and nonhealth care resources in a primary health care setting and the costs arising from the treatment of patients with FM under usual medical practice conditions recorded in a Spanish claims database. Information on the economic impact of FMS will be useful to clinicians, payers, and researchers

Objectives

Methods

Results

Discussion

Conclusion