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Pain Pract. 2011 Jul-Aug;11(4):381-91. doi: 10.1111/j.1533-2500.2010.00431.x. Epub 2010 Dec 29.

Medication adherence and healthcare costs among fibromyalgia patients treated with duloxetine.

Author information

1
Global Health Outcomes, Eli Lilly and Company, Indianapolis, Indiana 46221, USA. zhao_yang_yz@lilly.com

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 ≥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=30mg; Commercial: Odds ratio [OR]=3.03, 2.40, and 3.73 for 31 to 59mg, 60mg, and >60mg, respectively, all P<0.05; Medicare supplemental: OR=3.11, 2.33, and 4.76 for 31 to 59mg, 60mg, and >60mg, 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.

[Indexed for MEDLINE]

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