HealthDay News — Medication adherence is better for combination prescription initiators with fibromyalgia syndrome (FMS), although expenditures for total health care are higher with combination prescriptions, according to a study published in Pain Practice.

Nicole M. Marlow, PhD, from the University of Florida in Gainesville, and colleagues examined medication adherence and health care costs for combination prescription initiators (duloxetine/milnacipran/venlafaxine with pregabalin; 100 patients) vs monotherapy initiators (duloxetine, milnacipran, venlafaxine, and pregabalin; 1771 patients combined) among patients with FMS. Claims data for the South Carolina Blue Cross Blue Shield State Health Plan were evaluated.

The researchers found that the odds ratios for high adherence were significantly increased (P <.05) among the combination cohort vs the venlafaxine (2.15), duloxetine (1.39), and pregabalin (2.20) cohorts. For the combination cohort, expenditures for total health care were significantly higher (P <.05) vs duloxetine ($26,291 vs $17,190), milnacipran ($33,638 vs $22,886), and venlafaxine ($26,586 vs $16,857) cohorts.

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“Our findings suggest important clinical benefits with the use of combination prescription therapy, and prospective studies of medication adherence are warranted to examine causal relationships with outcomes not captured by health care claims databases,” the authors write.


Marlow NM, Simpson KN, Vaughn IA, Jo A, Zoller JS, Short EB. Healthcare costs and medication adherence among patients with fibromyalgia: combination medication vs. duloxetine, milnacipran, venlafaxine, and pregabalin initiators [published online May 28, 2017]. Pain Pract. doi:10.1111/papr.12585