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


METHODS
A 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.


RESULTS
Of 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 euro (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 euro (404 to 823, +66%) and 4,394 euro (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 euro (124 to 335, +64%, P < 0.001), than the reference group.


CONCLUSIONS
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.
Badalona Serveis Assistencials, C, Gaietà Soler, Badalona, Barcelona, Spain. asicras@bsa.gs
Antoni
A
Sicras-Mainar
Javier
J
Rejas
Ruth
R
Navarro
Milagrosa
M
Blanca
Angela
A
Morcillo
Raquel
R
Larios
Soledad
S
Velasco
Carme
C
Villarroya
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D012189:Retrospective Studies; D055815:Young Adult