We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Medication Adherence and Healthcare Costs among Fibromyalgia Patients Treated with Duloxetine.
- Authors
Zhao, Yang; Chen, Shih-Yin; Wu, Ning; Fraser, Kimberly A.; Boulanger, Luke
- Abstract
Objective: The study aims to examine predictors associated with duloxetine adherence and its association with healthcare costs among fibromyalgia patients. Methods: Administrative claims from both commercially and Medicare supplemental-insured fibromyalgia patents aged 18+ who initiated duloxetine in 2006 were analyzed. Initiation was defined as a 90-day clean period without duloxetine. The dispense date of the first duloxetine prescription was denoted as the index date. Two cohorts were constructed based on duloxetine adherence over the 12-month postindex period (high adherence as medication possession ratio 3 0.8). Predictors of high adherence were examined via logistic regression. Generalized linear regressions were performed to estimate the association between duloxetine adherence and healthcare costs. Results: A total of 4,869 commercially and 566 Medicare supplemental-insured fibromyalgia patients were identified. Two-thirds of patients had low adherence. Higher duloxetine average daily dose (ADD) was associated with increased adherence (reference group = 30 mg; Commercial: Odds ratio [OR] = 3.03, 2.40, and 3.73 for 31 to 59 mg, 60 mg, and > 60 mg, respectively, all P < 0.05; Medicare supplemental: OR = 3.11, 2.33, and 4.76 for 31 to 59 mg, 60 mg, and >60 mg, respectively, all P < 0.05). Commercially insured patients with high adherence had significantly lower total healthcare costs than low-adherence patients (-$1,164, P < 0.05), primarily because of lower inpatient (-$2,222, P < 0.05) and outpatient (-$1,075, P < 0.05) costs. Medicare supplemental-insured patients with high adherence had similar overall and inpatient costs, but significantly lower outpatient costs (-$2,025, P < 0.05). Conclusion: Fibromyalgia patients with higher duloxetine ADD were more likely to adhere to the therapy. High duloxetine adherence was associated with lower (Commercial) or similar (Medicare supplemental) healthcare costs.
- Subjects
UNITED States; CLINICAL drug trials; DRUG utilization; ANALYSIS of variance; CHI-squared test; COMPUTER software; CONFIDENCE intervals; DATABASES; EPIDEMIOLOGY; FIBROMYALGIA; LONGITUDINAL method; MEDICAL care costs; MULTIVARIATE analysis; NONPARAMETRIC statistics; PATIENT compliance; REGRESSION analysis; RESEARCH funding; STATISTICS; T-test (Statistics); COMORBIDITY; LOGISTIC regression analysis; DATA analysis; EMPIRICAL research; RETROSPECTIVE studies; DULOXETINE; ECONOMICS
- Publication
Pain Practice, 2011, Vol 11, Issue 4, p381
- ISSN
1530-7085
- Publication type
Article
- DOI
10.1111/j.1533-2500.2010.00431.x