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Lost productivity costs outweigh healthcare costs for Fibromyalgia patients at all severity levels
Friday 17 August 2012
By Arthi Chandran, et al.
[Note: The full text of this article is available free here. ‘Indirect costs’ are the value of lost productivity and unpaid caregiver time. ‘Direct costs’ are costs of health resources used.]
Objectives: To assess:
a) HRU, direct and indirect costs associated with fibromyalgia in routine clinical practice in the United States using a patient-centric approach, and
b) The relationship of fibromyalgia severity level to HRU and costs.
This study recruited a nonprobability convenience sample of 203 subjects aged 18 through 65 years between August 2008 and February 2009 from 20 U.S. community-based physician offices.
Subjects had a prior diagnosis of fibromyalgia by a rheumatologist, neurologist, or pain specialist; received treatment at the enrolling physician's practice for at least 3 months; experienced widespread pain for at least 3 months; and experienced pain in the previous 24 hours.
Subjects completed a 106-item patient questionnaire that included 5 validated health-related quality-of-life instruments and study-specific questions about demographics; clinical history; overall health; treatment satisfaction; and impact of fibromyalgia on cognitive function, daily activities, and employment status.
Subjects also self-reported:
…for the previous 4 weeks.
The 20-item Fibromyalgia Impact Questionnaire total score was used to stratify subjects into fibromyalgia severity groups:
Staff at each site recorded clinical characteristics, health resource use (HRU), and medication use attributable to fibromyalgia on a paper clinical case report form (CRF) based on a 3-month retrospective medical chart review.
Unit costs for 2009 were assigned to the 3-month HRU data reported on the CRF and 4-week subject-reported lost productivity.
Costs were then annualized and reported in the following categories:
Differences across severity levels were evaluated using the Kruskal-Wallis test (continuous measures) and Pearson chi-square or Fisher's exact tests (categorical measures) at the 0.05 alpha level.
Of the 203 subjects, 21 (10.3%) had mild, 49 (24.1%) had moderate, and 133 (65.5%) had severe fibromyalgia.
For subjects with mild, moderate, and severe fibromyalgia, respectively:
…significantly differed across severity levels.
Across severity levels, total medical and nonmedical out-of-pocket costs also differed (P?=?0.025).
Source: Journal of Managed Care Pharmacy, Jul 2012;18(6):415-26. PMID:22839682, by Chandran A, Schaefer C, Ryan K, Baik R, McNett M, Zlateva G. Covance Market Access Services, Inc., Gaithersburg, Maryland, USA. [Email: Caroline.Schaefer@covance.com]
The above originally appeared here.
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