title: Prospective study of the use of healthcare resources and economic costs in patients with fibromyalgia after treatment in routine medical practice.
abstract: OBJECTIVE
  To estimate the burden and to prospectively analyse resources utilisation and costs in a cohort of treated patients with fibromyalgia (FM) in daily practice.
  
  
  METHODS
  Prospective, observational, multicentre, 3-month study in 232 patients with FM according to the ACR criteria (98% women, 47 years), with no concomitant systemic diseases, followed in rheumatology units. The control group consisted of 110 subjects without FM or any other systemic condition, paired by age and gender. Clinical assessment, use of healthcare resources and treatments, out-of-pocket expenses, occupational status, days off work, and calculation of lost workdays equivalents were recorded.
  
  
  RESULTS
  Patients had worse clinical status, four times the control group's healthcare costs, twelve times its indirect costs and six times its total costs. After the treatment, there was significant clinical improvement in the patient group, the healthcare costs were significantly reduced in all components except for drugs costs, which increased (p<0.001), and out-of-pocket expenses, which remained unaltered. Indirect costs were reduced (p<0.05) in the FM group only, mainly due to fewer days off work. The patient group presented a significantly greater variation in montly total costs than the controls; -€193.75 ± 781.9 vs. -€26.22 ± 402.7, p=0.006. The patients who most reduced their healthcare costs were actively employed.
  
  
  CONCLUSIONS
  Treated patients with FM in daily practice improved their clinical status and were accompanied by a significant reduction in the cost of the illness. The extra cost of drugs is substantially compensated for by less use of other healthcare resources and fewer days off work.
authors.affiliation: Rheumatology Unit, Instituto Provincial de Rehabilitación, Hospital General Universitario Gregorio Marañón, Madrid, Spain. javierrivera@ser.es
authors.forename: Javier
authors.initials: J
authors.lastname: Rivera
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas-Gutiérrez
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Vallejo
authors.forename: Joaquín
authors.initials: J
authors.lastname: Esteve-Vives
authors.forename: Marina
authors.initials: M
authors.lastname: De Salas-Cansado
mesh_terms: D000041:Absenteeism; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004651:Employment / Q000191:economics; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018582:Sick Leave / Q000191:economics; D013030:Spain; D013222:State Medicine / Q000191:economics / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome