gms | German Medical Science

15th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

20.11. - 21.11.2008, Bonn

Drug Utilization of Fibromyalgia-Syndrom (FMS) Patients – Results of a Statutory Health Insurance Claims Data Analysis

Arzneimittelinanspruchnahme von Patienten mit Fibromyalgie-Syndrom (FMS) – Ergebnisse der Analyse von Routineabrechnungsdaten einer gesetzlichen Krankenversicherung

Meeting Abstract

  • corresponding author H. Gothe - Health Services Research Division, IGES Institut GmbH, Berlin, Germany
  • J. Petri - IGES Institut GmbH, Berlin, Germany
  • G. Glaeske - Centre for Social Policy Research, University of Bremen, Bremen, Germany
  • B. Häussler - IGES Institut GmbH, Berlin, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 15. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Bonn, 20.-21.11.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. Doc08gaa29

The electronic version of this article is the complete one and can be found online at:

Published: November 6, 2008

© 2008 Gothe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background and aim: The Fibromyalgia-Syndrome (FMS) is a relatively new disease pattern, which has been defined for the first time in 1990 based on the criteria catalogue of the American College of Rheumatology (ACR). By now the syndrome has been granted increasing attention and recommendations for diagnostics and drug therapy have been presented on this year's 26th Congress on Rheumatism ( The aim of the study at hand is to analyse the medical care of FMS under routine care conditions.

Material and method: Based on claims data of a major Statutory Health Insurance, which includes a nationwide group of about 1,5 million insured people, the medical care of Fibromyalgia patients with pharmaceuticals is presented. The identification of FMS patients is based on the specific ICD-10 codes for Fibromyalgia (M79.7) which have been available only since 2005. The group of persons which have been insured throughout the period between 01/01/2004 and 12/31/2006 (n=1,103,968) form the population. From these, beneficiaries have been selected, for whom at least either one outpatient and/or inpatient case and/or one sick leave event with the diagnosis M79.9, has been reported for the year 2005.

Results: All in all an amount of n=1,395 beneficiaries, who fulfilled the inclusion criteria, were eligible into the FMS study population. In this cohort the number of men (n=234; 16.8 %) was considerably smaller than the number of women (n=1,161; 83.2 %). Male and female middle-aged insured (41–50, 51–60 and 61–70 years) formed the major proportion of the study cohort (n=1,154; 82.7 %). 407 patients (29.1 %) of the selected group did not have a (primary or secondary) M79*classification diagnosis in the 360 days prior to the first documented M79.7 diagnosis and for this reason have been defined as an index case. N=1,153 (82.7 %) beneficiaries of the study cohort received their first FMS diagnosis as an outpatient. In most cases the primary diagnosis was made by general practitioners, internists and orthopaedists. Nearly all of the beneficiaries received drug prescriptions in the years 2004, 2005 and 2006 (2004: n=1,343; 96.3 %; 2005: n=1,369; 98.1 %; 2006: n=1,342; 96.2 %). 15 of the most common active substances made up to nearly half of all prescriptions (2004: 43.5 %; 2005: 48.9 %; 2006: 47.1 %). Among those where Diclofenac (rank 1 in 2004; rank 2 in 2005 and 2006) as well as in downward order (relating to 2004) Levothyroxin-Natrium, Amitriptylin, Ibuprofen and Tilidin/Combinations. An exception are those prescriptions, which presented the highest individual item among the most commonly prescribed substances in the years 2005 and 2006 (rank 2 in 2004). During the observation period the cost for pharmaceuticals for FMS patients have increased from 419,000€ (2004) beyond 483,000€ (2005) up to 581,000€ (2006). However, the increase in costs can mainly be blamed on the general price development of pharmaceuticals.

Conclusion: Among the most commonly prescribed active substances, analgesics like Diclofenac and antidepressants like Amitryptilin can be found, i.e. these are substances for which a high clinical evidence exists due to their long-term availability. For this reason they are explicitly mentioned in the draft of the national treatment recommendations. As prescription patterns of certain substance groups, which could indicate to FMS, could not be observed in the insured population, an identification of FMS patients by means of pharmaceutical prescriptions is not possible for the time before 2005 due to the lack of ICD codes for FMS.