March 27, 2008
Health economic consequences related to the diagnosis of fibromyalgia syndrome
Posted by linzworld under FM Theories/Hypotheses, Fibro research, National Campaign Action, Uncategorized | Tags: cost, economic, Fibro, Fibromyalgia, financial, FM, FMS, National health Service, NHS, saving, Wessely |
Researchers at IMS Health, Brussels and Ghent University, Belgium have published an article in the journal Arthritis and Rheumatism in which they discuss a study evaluating the health economic consequences related to the diagnosis of fibromyalgia syndrome.
People who have worked with the ME community will recognise the name of Simon Wessely amongst the researchers - Dr Wessely is not thought of highly amongst the ME community because of his theories on the psychological basis of ME.
The study aimed to “evaluate the use and costs of medical resources before and after a diagnosis of fibromyalgia syndrome [Fibro] in a large primary care population in the UK.”
The researchers applied an existing data set for medical resource use among patients with a Fibro diagnosis. The patients in the dataset were observed to use 157 types of medical resource and the quantities of these medical resource use, both before and after the Fibro diagnosis, were multiplied by their costs in order to calculate the cost of care within the National Health Service, excluding hospital costs. These costs included general practitioner [GP] visits, drugs, referrals, and diagnostics.
A trend analysis was applied to the costs before diagnosis in order to predict what the later costs would have been if the Fibro diagnosis had never been made. These predicted costs were then compared with the observed costs after diagnosis.
The researchers found that, following a Fibro diagnosis, a decrease in costs was observed, as compared with the predicted costs if the diagnosis had not been made. In the 4 years after diagnosis, the average difference between the observed cost and the predicted cost if the diagnosis had not been made was £66.21 per 6 months per patient. The researchers noted that this “suggests that making the diagnosis leads to savings and a decrease in resource use.”
The main cost saving effect was observed for tests and imaging (£24.02 per 6 months), followed by pharmaceuticals (£22.27), referrals (£5.56), and GP visits (£4.36).
The researchers concluded that:
“Failure to diagnose a true case of FMS has its own costs, largely in excess GP visits, investigations, and prescriptions.”
This study should be used by the NHS to prove the need, in purely financial terms, for better diagnosis of Fibro. However the study, like others before it, does not take into account the number of patients who were given a Fibro diagnosis and then told that there was nothing that could be done for them. I have heard this has happened many times from other patients and it happened to me - all the tests leading up to a rheumatology appointment at which you get given the Fibro diagnosis, maybe told of a few drugs to try if you are lucky, and are then discharged with a statement along the lines of “there is nothing else I can do for you” or “I don’t treat Fibromyalgia”. Not treating Fibromyalgia is obviously a huge cost saving for the NHS and this may actually be a factor in why it is so hard to get specialist services for Fibro from the NHS - the cost of paying for it could cripple the NHS singlehandedly.
