Effectiveness of pharmacotherapy for fibromyalgia syndrome: A medication adherence and costs perspective

Fibromyalgia syndrome (FMS) is associated with considerably increased disease related costs when compared to those without FMS. We used administrative claims data for South Carolina Blue Cross Blue Shield State Health Plan enrollees to examine medication adherence, use of concomitant medications, and healthcare costs for patients with FMS initiating duloxetine, milnacipran, pregabalin, or combination Rx (duloxetine/milnacipran with pregabalin). Predictors of healthcare costs were also evaluated within each Rx group cohort, focusing on medication adherence. We observed superior medication adherence as well as costs neutrality for inpatient and/or outpatient medical services with use of combination Rx (versus duloxetine, milnacipran, or pregabalin monotherapy). Moreover, healthcare expenditures for these medical services significantly decreased with increasing MPRs and days of therapy among the combination Rx cohort. These results are suggestive of important clinical and economic benefits for patients with FMS who include duloxetine/milnacipran with pregabalin combination pharmacotherapy as part of their multi-modal treatment regimen.