Table 4.
Unadjusted average annual FM-related cost ($) per fibromyalgia subjecta
| US
|
France
|
Germany
|
P-valuec | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Patients utilizing (%)b | Mean cost (SD) | Median cost (range) | Patients utilizing (%) | Mean cost (SD) | Median cost (range) | Patients utilizing (%) | Mean cost (SD) | Median cost(range) | ||
| Direct medical costs to payer | ||||||||||
| Physician visits | 203 (100.0) | 1528 (1953) | 806 (262–14,057) | 70 (100.0) | 297 (200) | 304 (101–1216) | 169 (100.0) | 564 (262) | 518 (94–1419) | <0.00l |
| Diagnostic tests | 55 (27.1) | 435 (1859) | 0 (0–15,858) | 14 (20.0) | 18 (48) | 0 (0–271) | 63 (37.3) | 39 (81) | 0 (0–487) | 0.048 |
| Prescription medications | 186 (91.6) | 3419 (3667) | 2375 (0–19,504) | 53 (75.7) | 312 (430) | 125 (0–2027) | 152 (89.9) | 606 (1344) | 224 (0–11,166) | <0.00l |
| Emergency room visits | 11 (5.4) | 43 (223) | 0 (0–2295) | NR | NR | NR | NR | NR | NR | NA |
| Hospitalizations | 0 (0.0) | 0 (0.0) | 0 (0–0) | 0 (0.0) | 0 (0) | 0 (0–0) | 2 (1.2) | 152 (1397) | 0 (0–12,879) | 0.198 |
| Direct medical costs to subject | 180 (88.7) | 1798 (3056) | 975 (0–35,100) | 22 (31.4) | 223 (515) | 0 (0–2993) | 121 (71.6) | 576 (1272) | 320 (0–12,046) | <0.00l |
| Direct nonmedical costs to subject | ||||||||||
| Professional services for ADL | 62 (30.5) | 750 (1756) | 0 (0–13,000) | 5 (7.1) | 74 (363) | 0 (0–2694) | 38 (22.5) | 297 (740) | 0 (0–5126) | <0.00l |
| Total direct costs | 203 (100.0) | 7973 (7341) | 6105 (262–57,102) | 70 (100.0) | 924 (862) | 673 (101–4967) | 169 (100.0) | 2234 (2641) | 1486 (251–17,368) | <0.00l |
| Indirect costs to society | ||||||||||
| Lost productivity due to absenteeism | 33 (16.3) | 1228 (4904) | 0 (0–57,891) | 5 (7.1) | 2407 (9978) | 0 (0–51,838) | 32 (18.9) | 2300 (7356) | 0 (0–55,926) | 0.093 |
| Lost productivity due to disability | 36 (17.7) | 7333 (15,833) | 0 (0–41,350) | 12 (17.1) | 7413 (16,414) | 0 (0–43,240) | 21 (12.4) | 5598 (14,904) | 0 (0–45,047) | 0.684 |
| Disability payments | 36 (17.7) | 2137 (4613) | 0 (0–12,048) | NR | NR | NR | NR | NR | NR | NA |
| Total indirect costs | 69 (34.0) | 10,697 (20,463) | 0 (0–57,891) | 17 (24.3) | 9819 (18,242) | 0 (0–51,838) | 53 (314) | 7898 (15,822) | 0 (0–55,926) | 0.260 |
| Total direct and indirect costs | 203 (100.0) | 18,671 (22,848) | 7893 (262–80,555) | 70 (100.0) | 10,743 (18,457) | 815 (101–52,511) | 169 (100.0) | 10,132 (16,053) | 2605 (251–62,176) | <0.001 |
Notes:
a
Unadjusted for confounding variables;
b
number of patients (%) utilizing the service and incurring the cost (US, n = 203; France, n = 70; Germany, n = 169);
c
Kruskal-Wallis test for costs from each country; all costs are in 2009 US dollars.
Abbreviations: NR, not reported; NA, not assessed; ADL, activities of daily living; SD, standard deviation.