DIRECT HEALTH COSTS OF TREATING PATIENTS WITH FIBROMYALGIA IN PRIMARY CARE SETTINGS (PCS) UNDER ROUTINE MEDICAL PRACTICE- A COST OF ILLNESS STUDY USING A CLAIM DATABASE IN SPAIN.
Author(s)
Antoni Sicras, MD, Head of Information Systems1, Javier Rejas, MD, Outcomes Research Manager2, Ruth Navarro, MD, Head of Medical Documentation1, Milagrosa Blanca, MD, -------------------------------3, Angela Morcillo, Nurse, Nurse4, Raquel Larios, Nurse, Nurse4, Soledad Velasco, MD, Public Health Department1, Carme Villarroya, Nurse, Nurse41Badalona Servicios Asistenciales, Barcelona, Spain; 2 Pfizer Spain, Madrid, Spain; 3 Badalona Serveis Assistencials, Badalona, Barcelona, Spain; 4 Badalona Serveis Assistencials, Badalona (Barcelona), Spain
OBJECTIVES: To analyze a health resources utilization claim database in order to derive direct health costs of treating patients with Fibromyalgia under routine medical practice at PCS. METHODS: A 12-month retrospective study was performed using computerized medical records from a health provider database; BSA. Analysis was conducted from a 3r-payer perspective during the year 2006. Health resources utilization included both those of the primary care (PC) level (drugs, complementary tests, medical visits, etc.) and those of the specialized care (SC) as well. SC included emergency visits, hospitalizations, and tests and drugs prescribed by specialist. Men and women above 18-years included in the data base (n=63,526) were analyzed. Fibromyalgia was diagnosed according with CIE-10 criteria. Descriptive statistics and ANCOVA models were used. RESULTS: One-thousand-eighty-one subjects [96.7% women, 54.2 (10.1) years] fulfilled CIE-10 criteria for Fibromyalgia amongst the 63,526 database subjects: 1.7%. Charlson index was no different in Fibromyalgia patients vs controls (the rest of sample analyzed), p=0.212. After adjusting by age and sex, yearly total health costs per patient were €614 higher (+66%) on average in Fibromyalgia than in controls; €1,550 (95% CI: 1,341-1,760) vs. €937 (927-945), p<0.0001. Both PC and SC annual costs were significantly higher in Fibro patients; mean per patient adjusted difference of €395 (276-513, p<0.0001) and €219 (74-364, p=0.003), respectively. Total annual drug costs were considerably higher in patients with Fibromyalgia; €591 (485-696) vs. €361 (356-366), p<0.0001. Age correlated moderate but significantly with yearly PC, drug and total per patient health costs; r=0.324, 0.325, and 0.278, respectively, p<0.001 in all cases. CONCLUSION: Compared with controls, subjects with Fibromyalgia were associated to higher annual total direct health costs in the primary care setting. Drugs represented a considerable portion of health resources costs devoted to these patients. Age, but not sex, was associated with higher costs.
Conference/Value in Health Info
2007-10, ISPOR Europe 2007, Dublin, Ireland
Value in Health, Vol. 10, No. 6 (November/December 2007)
Code
PMS1
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Musculoskeletal Disorders