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Patients with <jats:styled-content style=\"fixed-case\">FMS<\/jats:styled-content> \u2265 18 years of age, with prescription initiation from July 1, 2007, through June 30, 2010, and <jats:styled-content style=\"fixed-case\">SHP<\/jats:styled-content> enrollment for 12 months pre\u2010 and post\u2010index periods were included (combination: <jats:italic>n<\/jats:italic> = 100; pregabalin: <jats:italic>n<\/jats:italic> = 665; duloxetine: <jats:italic>n<\/jats:italic> = 713; milnacipran: <jats:italic>n<\/jats:italic> = 131; venlafaxine: <jats:italic>n<\/jats:italic> = 272). Medication adherence measures included high adherence (medication possession ratio \u2265 80%) and total supply days. Healthcare costs comprised direct medical expenditures. Propensity score methods of inverse probability of treatment weights were used to control for selection bias due to differing pre\u2010index characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Odds ratios for high adherence were significantly increased (<jats:italic>P &lt;<\/jats:italic> 0.05) among the combination cohort vs. the venlafaxine (2.15), duloxetine (1.39), and pregabalin (2.20) cohorts. Rate ratios for total supply days were significantly higher (<jats:italic>P &lt;<\/jats:italic> 0.05) for combination vs. venlafaxine (1.23), duloxetine (1.08), and pregabalin (1.32) cohorts. Expenditures for total health care were significantly higher (<jats:italic>P &lt;<\/jats:italic> 0.05) for combination vs. duloxetine ($26,291 vs. $17,190), milnacipran ($33,638 vs. $22,886), and venlafaxine ($26,586 vs. $16,857) cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Medication adherence was considerably better for combination prescription initiators; however, expenditures for total health care were higher. Still, 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 healthcare claims databases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12585","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T15:49:02Z","timestamp":1492530542000},"page":"154-169","source":"Crossref","is-referenced-by-count":14,"title":["Healthcare Costs and Medication Adherence Among Patients with Fibromyalgia: Combination Medication vs. Duloxetine, Milnacipran, Venlafaxine, and Pregabalin Initiators"],"prefix":"10.1111","volume":"18","author":[{"given":"Nicole M.","family":"Marlow","sequence":"first","affiliation":[{"name":"Department of Health Services Research, Management and Policy College of Public Health and Health Professions University of Florida Gainesville Florida 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