title: Duloxetine use in employees with low back pain: treatment patterns and direct and indirect costs.
abstract: OBJECTIVE
  The study aims to examine real-world effects of duloxetine treatment for low back pain (LBP).
  
  
  METHODS
  The study identified employees with ≥1 LBP diagnosis and ≥1 duloxetine prescription within a year after LBP diagnosis from a privately insured claims database (2004-2007). Duloxetine-treated employees were propensity score matched to employees initiating another pharmacological/noninvasive treatment in the same month from LBP diagnosis. Treatment patterns and costs were compared over the 6 months following treatment initiation.
  
  
  RESULTS
  Relative to controls, duloxetine-treated employees (N = 753) had significantly lower rates of other pharmacological/noninvasive therapies and a similar LBP surgery rate (1.7% vs 2.8%, P = 0.1573). Duloxetine-treated employees, despite higher pharmacy costs, had similar direct (health care) costs ($4,935 vs $5,649, P = 0.2662), and significantly lower indirect (workloss) costs ($1,723 vs $2,198, P = 0.0036).
  
  
  CONCLUSIONS
  Duloxetine treatment in LBP employees was associated with reduced rates of many nonsurgical therapies and lower indirect costs. The findings are limited by the observational study design and unmeasured potential confounders.
authors: Analysis Group, Inc., New York, New York, USA.
authors: Jasmina I
authors: JI
authors: Ivanova
authors: Howard G
authors: HG
authors: Birnbaum
authors: Evan
authors: E
authors: Kantor
authors: Matt
authors: M
authors: Schiller
authors: Ralph W
authors: RW
authors: Swindle
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride; D005260:Female; D017048:Health Care Costs; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000191:economics*; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000191:economics*; D012189:Retrospective Studies; D013876:Thiophenes / Q000191:economics* / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride
keywords: Direct and Indirect Costs; Duloxetine; Low Back Pain; Treatment Pattern