Rheumatology Unit, Instituto Provincial de Rehabilitación, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Exp Rheumatol. 2012 Nov-Dec;30(6 Suppl 74):31-8. Epub 2012 Dec 14.
To estimate the burden and to prospectively analyse resources utilisation and costs in a cohort of treated patients with fibromyalgia (FM) in daily practice.
Prospective, observational, multicentre, 3-month study in 232 patients with FM according to the ACR criteria (98% women, 47 years), with no concomitant systemic diseases, followed in rheumatology units. The control group consisted of 110 subjects without FM or any other systemic condition, paired by age and gender. Clinical assessment, use of healthcare resources and treatments, out-of-pocket expenses, occupational status, days off work, and calculation of lost workdays equivalents were recorded.
Patients had worse clinical status, four times the control group's healthcare costs, twelve times its indirect costs and six times its total costs. After the treatment, there was significant clinical improvement in the patient group, the healthcare costs were significantly reduced in all components except for drugs costs, which increased (p<0.001), and out-of-pocket expenses, which remained unaltered. Indirect costs were reduced (p<0.05) in the FM group only, mainly due to fewer days off work. The patient group presented a significantly greater variation in montly total costs than the controls; -€193.75 ± 781.9 vs. -€26.22 ± 402.7, p=0.006. The patients who most reduced their healthcare costs were actively employed.
Treated patients with FM in daily practice improved their clinical status and were accompanied by a significant reduction in the cost of the illness. The extra cost of drugs is substantially compensated for by less use of other healthcare resources and fewer days off work.
估计负担，并前瞻性分析在日常实践中接受治疗的纤维肌痛（FM）患者队列中的资源利用和成本。
对 232 名符合 ACR 标准的 FM 患者（98%为女性，47 岁）进行前瞻性、观察性、多中心、3 个月研究，无合并系统性疾病，在风湿病科就诊。对照组由 110 名无 FM 或任何其他系统性疾病的患者组成，年龄和性别配对。记录临床评估、医疗资源和治疗的使用、自付费用、职业状况、休假天数以及计算丧失工作日的等效天数。
患者的临床状况较差，医疗费用是对照组的四倍，间接费用是对照组的十二倍，总费用是对照组的六倍。经过治疗，患者组的临床状况显著改善，除药物费用（增加）（p<0.001）和自付费用（保持不变）外，所有医疗成本均显著降低。仅 FM 组的间接费用减少（p<0.05），主要是由于休假天数减少。患者组的每月总费用变化明显大于对照组；-€193.75 ± 781.9 比 -€26.22 ± 402.7，p=0.006。医疗费用降低最多的患者为在职患者。
在日常实践中接受治疗的 FM 患者的临床状况得到改善，同时疾病的治疗费用显著降低。药物费用的额外支出在很大程度上被其他医疗资源使用减少和休假天数减少所抵消。
