Use of complementary and alternative medicine providers by fibromyalgia patients under insurance coverage

Abstract

Objective: To quantify how visits and expenditures differ between insured patients with fibromyalgia syndrome (FMS) who visit complementary and alternative medicine (CAM) providers compared with patients with FMS who do not. Patients with FMS were also compared with an age- and sex-matched comparison group without FMS.

Methods: Calendar year 2002 claims data from 2 large insurers in Washington state were analyzed for provider type (CAM versus conventional), patient comorbid medical conditions, number of visits, and expenditures.

Results: Use of CAM by patients with FMS was 2.5 times higher than in the comparison group without FMS (56% versus 21%). Patients with FMS who used CAM had more health care visits than patients with FMS not using CAM (34 versus 23; P < 0.001); however, CAM users had similar expenditures to nonusers among patients with FMS ($4,638 versus $4,728; not significant), because expenditure per CAM visit is lower than expenditure per conventional visit. Patients with FMS who used CAM also had heavier overall disease burdens than those not using CAM.

Conclusion: With insurance coverage, a majority of patients with FMS will visit CAM providers. The sickest patients use more CAM, leading to an increased number of health care visits. However, CAM use is not associated with higher overall expenditures. Until a cure for FMS is found, CAM providers may offer an economic alternative for patients with FMS seeking symptomatic relief.

Figure 1

Average annual outpatient visits by FMS patients and the comparison group, separated by CAM use

Figure 2

Average annual outpatient expenditures by FMS patients and the comparison group, separated by CAM use