571: Healthcare Costs of Fibromyalgia in Brazil in 2023: A Cost-of-Illness Study

Topic: Education, Societal Impact, and Others
Subtopic: Economics

Background and Aims: Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain¹. Fibromyalgia affects 2–4% of the population and is associated with substantial utilization, with annual per-patient estimates of US$1,750 to US$35,920 in the United States and US$1,250 to US$8,504 in Europe². Fibromyalgia is associated with up to three times higher healthcare costs than other chronic pain conditions³. Although there is evidence of the economic burden of fibromyalgia in high-income countries, this information is scarce in low- and middle-income countries. This study aimed to estimate healthcare costs of fibromyalgia in the Brazilian healthcare system in 2023.

Methods: This cost-of-illness study was conducted from the SUS perspective with a time horizon of 12 months using a top-down approach. Healthcare costs included inpatient and outpatient costs derived from the SUS information system. Inpatient care comprised personnel, in-hospital, and intensive care unit services. Outpatient care comprised diagnostic, clinical, and minor surgical procedures, assistive devices, and supplementary services. Data were extracted considering adults aged 18 years or older, both sexes with fibromyalgia identified by the International Classification of Diseases, Tenth Revision (ICD-10) code M79.7. Healthcare costs of fibromyalgia in 2023 were descriptively analyzed, with inpatient and outpatient costs reported separately.

Results: Healthcare costs of fibromyalgia in Brazil were US$648,358 in 2023, corresponding to 368,813 services. Outpatient care accounted for 95% of costs (US$612,749), whereas inpatient care represented 5% (US$35,610). In outpatient care, clinical procedures accounted for the largest share of costs (71%; US$432,513), followed by diagnostic procedures (28%; US$171,476.65). The most common clinical procedure was physiotherapy; complementary actions, surgical procedures, and orthoses contributed minimally. In inpatient care, hospital services accounted for the largest share of costs (85%; US$30,152), while intensive care unit costs were minimal (4%; US$1,475.41).

Conclusions: Direct healthcare costs of fibromyalgia identified in the Brazilian Unified Health System likely underestimate the true burden of the condition. Diagnostic complexity, symptom overlap, and frequent comorbidities may lead to under-recognition and misclassification of fibromyalgia in administrative databases, limiting ICD-based identification. Consequently, healthcare utilization related to fibromyalgia may be partially captured under other musculoskeletal or pain-related diagnoses. These findings highlight the need for cautious interpretation of administrative cost estimates and underscore the importance of improved diagnostic coding to better characterize the healthcare burden of fibromyalgia.

References: 1. Amris, K., Ibsen, R., Duhn, P. H., et al. “Health inequities and societal costs for patients with fibromyalgia and their spouses : a Danish cohort study,” 2024, pp. 1–11.
2. D’Onghia, M., Ciaffi, J., Ruscitti, P., et al. “The economic burden of fibromyalgia: A systematic literature review,” Seminars in Arthritis and Rheumatism, V. 56, 2022.
3. Souza, J. B. de., and Perissinotti, D. M. N. “The prevalence of fibromyalgia in Brazil – a population-based study with secondary data of the study on chronic pain prevalence in Brazil,” V. 1, No. 4, 2018, pp. 345–8.

Presenting Author: Melissa Galvao
Submitting Author: Lidia Ester Oliveira Cruz

Senior Author: Gisela Cristiane Miyamoto

IASP 2026 Global Year theme of Neuropathic Pain: No

• Beatriz Pimentel Santana: Bachelor’s degree (in progress) - University of the City of São Paulo
• Gisela Cristiane Miyamoto: PhD - University of São Paulo