Patterns of healthcare utilization and cost in patients with newly diagnosed fibromyalgia.
OBJECTIVE
To compare healthcare utilization and costs in the year preceding and following initial diagnosis of fibromyalgia (FM).


METHODS
Using a large US health insurance claims database, we identified all persons with newly diagnosed FM (International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 729.1) between January 1, 2003, and December 31, 2005 ("FM patients"). Each patient's first-noted claim with a diagnosis of FM was designated the "index date," and all pharmacy, outpatient, and inpatient claims were compiled over the 12-month periods preceding and following this date ("prediagnosis" and "postdiagnosis," respectively). Patients with incomplete pre- or postdiagnosis data were excluded. Healthcare utilization and costs were compared between the 2 periods.


RESULTS
A total of 1803 patients met all study inclusion criteria; mean (SD) age was 50.4 (9.4) years; 91% were women. Comorbidities were common, including arthritis (21% of study subjects), back pain (20%), and painful neuropathic disorders (16%). The percentage of study subjects receiving various pain-related medications increased from pre- to postdiagnosis, including opioids (51.3% vs 55.9%), antiepileptics (22.6% vs 28.6%), and tricyclic antidepressants (15.5% vs 21.2%) (all P <.01). Mean total healthcare costs also increased by $1725 between these periods (mean [95% confidence interval]: $9324 [$8655, $10,092] vs $11,049 [$10,245, $11,973], respectively; P <.01).


CONCLUSIONS
Patients with FM are often seen for other medical problems prior to initial diagnosis. Levels of healthcare utilization and costs are high during both the pre- and postdiagnosis periods.
Berger
Ariel
A
Policy Analysis Inc, Four Davis Ct, Brookline, MA 02445, USA. goster@pai2.com
Sadosky
Alesia
A
Dukes
Ellen M
EM
Edelsberg
John
J
Zlateva
Gergana
G
Oster
Gerry
G
D000328:Adult; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use; D015897:Comorbidity; D003365:Costs and Cost Analysis; D004363:Drug Utilization; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy / Q000191:economics* / Q000628:therapy*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged
D000700:Analgesics; D000701:Analgesics, Opioid