Jeffery Diana D, Bulathsinhala Lakmini, Kroc Michelle, Dorris Joseph
Department of Defense, Defense Health Agency, 7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101.
U.S. Army Research Institute of Environmental Medicine, Kansas Street, Natick, MA 01760-5007.
Mil Med. 2014 Sep;179(9):1021-9. doi: 10.7205/MILMED-D-13-00419.
We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs.
We used military health care claims from October 2006 to September 2010.
STUDY DESIGN/ANALYSIS: Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models.
Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person).
Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS.
我们比较了被诊断为纤维肌痛综合征(FMS)、肠易激综合征(IBS)和慢性疲劳综合征(CFS)的非老年成年人在联邦批准FMS药物前后的患病率、医疗保健利用率及成本随时间的变化情况。
我们使用了2006年10月至2010年9月的军事医疗保健索赔数据。
研究设计/分析:采用趋势分析和基于时间序列回归的广义线性模型进行回顾性多年比较。
在5年时间里,FMS患病率从0.307%升至0.522%,而IBS和CFS患病率保持稳定。FMS患病率的最大增幅出现在2007年至2008年之间。与IBS和CFS病例相比,FMS病例的医疗保健利用率更高。在5年时间里,FMS相关护理的总成本增加了1.632亿美元,而IBS成本增加了1490万美元,CFS成本增加了370万美元。2006年至2010年期间,FMS病例的药房总成本从5500万美元(人均3641美元)增至9630万美元(人均3557美元)。
尽管无法确定因果关系,但联邦批准的FMS药物的出现以及制药行业对这些药物的营销,与FMS相对于IBS和CFS在患病率、医疗保健利用率和成本方面的观察到的变化相吻合。