A large part of healthcare costs for fibromyalgia patients consists of physician visits and medications, and factors such as the simultaneous presence of other diseases contribute to increased costs.
Identifying patients with high resource needs may guide researchers and clinicians in the establishment of strategies that can improve patient outcomes and help reduce healthcare costs.
The study, “Evaluating increased resource use in fibromyalgia using electronic health records,” was performed by Truven Health Analytics and Pfizer, and published in the journal ClinicoEconomics and Outcomes Research.
Researchers used retrospective data from an electronic health records database to better understand drivers of healthcare costs. The database held information on 64,038 eligible fibromyalgia patients, of whom 81.4 percent were women and 87.7 percent were of European descent.
Nearly all the patients, 91.6 percent, had costs linked to medication, and 87.5 percent had visited doctors. In addition, 50.3 percent had “other outpatient visits,” and 25.3 percent had lab tests done. Contributors to healthcare costs used by far fewer patients were inpatient admissions, radiology treatments, and physical therapy.
Looking specifically at the types of medication used, opioids were the most common group, used by 44.3 percent of patients. Importantly, researchers noted that 82.4 percent of patients taking opioids had prescriptions that were not within fibromyalgia guidelines.
Non-steroid anti-inflammatory drugs and skeletal muscle relaxants were next in line, used by 34.4 percent and 29.1 percent, respectively. Collectively, various drugs used for depression and anxiety made up a large proportion of the medication used by these fibromyalgia patients.
Analyzing factors that drove healthcare costs, the team discovered that a history of frequent healthcare visits was linked to higher numbers of physician visits later during the disease course.
African-American women had more healthcare visits than Caucasian patients. Also, patients with other diseases more often sought care. The increases varied according to the condition, and ranged from a 6 percent increase among those having musculoskeletal pain, depression, or bipolar disorder to a 21 percent increase in patients with congestive heart failure.
Using opioids outside of fibromyalgia guidelines was also linked to more frequent healthcare visits, both compared to patients not using opioids and to those using opioids within the limits.
“Physician office visits and pharmacotherapy orders were key drivers of all-cause healthcare utilization, with demographic factors, opioid use, and specific comorbidities associated with resource intensity,” the team wrote. “Health systems and providers may find their EHRs [electronic health records] to be a useful tool for identifying and managing resource-intensive [fibromyalgia] patients.”
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