title: Humanistic and economic burden of fibromyalgia in Japan.
abstract: OBJECTIVE
  The aim of this study was to examine the health and economic burden associated with fibromyalgia among adults in Japan.
  
  
  METHODS
  Data from the 2011-2014 Japan National Health and Wellness Survey (n=115,271), a nationally representative survey of adults, were analyzed. The greedy matching algorithm was used to match the respondents who self-reported a diagnosis of fibromyalgia with those not having fibromyalgia (n=256). Generalized linear models, controlling for covariates (eg, age and sex), examined whether the respondents with fibromyalgia differed from matched controls based on health status (health utilities; Mental and Physical Component Summary scores from Medical Outcomes Study: 12-item Version 2 and 36-item Version 2 Short Form Survey), sleep quality (ie, sleep difficulty symptoms), work productivity (Work Productivity and Activity Impairment Questionnaire - General Health Version 2.0), health care resource use, and estimated annual indirect and direct costs (based on published annual wages and resource use events) in Japanese yen (¥).
  
  
  RESULTS
  After adjustment for covariates, respondents with fibromyalgia relative to matched controls scored significantly lower on health utilities (adjusted means =0.547 vs 0.732), Mental Component Summary score (33.15 vs 45.88), and Physical Component Summary score (39.22 vs 50.81), all withP<0.001; these differences exceeded the clinically meaningful levels. In addition, those with fibromyalgia reported significantly poorer sleep quality than those without fibromyalgia. Respondents with fibromyalgia compared with those without fibromyalgia experienced significantly more loss in work productivity and health care resource use, resulting in those with fibromyalgia incurring indirect costs that were more than twice as high (adjusted means =¥2,826,395 vs ¥1,201,547) and direct costs that were nearly six times as high (¥1,941,118 vs ¥335,140), both withP<0.001.
  
  
  CONCLUSIONS
  Japanese adults with fibromyalgia experienced significantly poorer health-related quality of life and greater loss in work productivity and health care use than those without fibromyalgia, resulting in significantly higher costs. Improving the rates of diagnosis and treatment for this chronic pain condition may be helpful in addressing this considerable humanistic and economic burden.
authors.affiliation: Health Outcomes Practice, Kantar Health, Foster City, CA, USA.
authors.forename: Lulu K
authors.initials: LK
authors.lastname: Lee
authors.affiliation: Neuroscience & Pain Medical Affairs, Pfizer Japan Inc., Tokyo, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Ebata
authors.affiliation: Global Health & Value, Pfizer Inc.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hlavacek
authors.affiliation: Health Outcomes Practice, Kantar Health, New York, NY.
authors.forename: Marco
authors.initials: M
authors.lastname: DiBonaventura
authors.affiliation: Statistics, Pfizer Inc., Groton, CT, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.affiliation: Global Health & Value, Pfizer Inc.
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
keywords: direct costs; health care resource use; health-related quality of life; indirect costs; sleep quality; work productivity loss