Objectives To estimate the cost of health care in primary fibromyalgia (FM) patients.
Methods All persons diagnosed as FM in our rheumatology outpatient clinic during the last 3 years and members of the Dutch FM patient association were invited to participate in a study on the social impact of FM. Only persons fulfilling ACR criteria for FM, aged 18–65, and without significant co-morbidity, were included. They completed a questionnaire on the impact of FM in the preceding six months, with questions regarding the type, amount and cost of health care they had received during this period. Mean cost was estimated using standardised prizes in Dutch guilders and transformed to Euros (?).
Results The questionnaire was completed by 135 persons (mean age 47 years, standard deviation SD 8.6, 128 females). They reported a mean number of 4 visits (SD 3) to their general practitioner for the six month period, (two of these (SD 2) because of FM) and a mean of 2 visits (SD 2) to medical specialists and 13 visits (SD 15) to health professionals, mainly physiotherapists. One person visited a rehabilitation centre for 1 day per week, 8 patients were admitted to hospital for not-FM related reasons. The mean cost of analgesics, anti-depressants and tranquillisers per six months was ? 52. Apart from this, a reported average of ? 17 was paid for homeopathic and other alternative drugs. Forty-two persons visited complementary or alternative therapists, at a mean cost of ? 61 per person. Participants reported an average of 10.8 (SD 31.5) hours of reimbursed domestic help. A mean sum of ? 159 was paid for devices and adaptations. The table shows estimated costs. Overall health care costs per person per year were ? 2333.
Discussion Since this is not a population-based study, we should consider the possibility of selection bias. On the other hand, in our retrospective study design recall bias may have caused an underestimation of true costs. Although exact data are lacking, we expect that cost of health professionals, complementary and alternative medicine and domestic help are mainly FM-related.
The estimated cost of health care for Dutch women aged 45–49 year is ? 1470 per person per year.
Conclusion The cost of health care in Dutch FM patients is approximately 60% higher than in the age-related general population. Therefore FM is not only a problem in terms of quality of life, but also in terms of health care economics.
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