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Fibromyalgia Patients’ Nonpain Symptoms Present Challenge for Drug Marketers Looking to Satisfy, According to Study by GfK Market Measures

Cymbalta, Lyrica and new entrants in fibromyalgia market must address complex range of symptoms and manage patient expectations through awareness and education to succeed

EAST HANOVER, NJ, July 30, 2008 — Fibromyalgia, a chronic condition within the neuropathic pain category, is complicated both in its initial diagnosis and ongoing treatment because of a wide range of pain and nonpain symptoms.  The success of drugs such as Cymbalta, Lyrica and future entrants in this market are dependent on marketers having a more holistic view of patient satisfaction as well as implementing awareness and education programs for physicians and patients, according to new research by GfK Market Measures. 

Among the four conditions that comprise the neuropathic pain category, which also includes diabetic neuropathic pain, postherpetic neuralgia and neuropathic lower back pain, fibromyalgia is recognized as particularly difficult to set a definitive diagnose despite criteria that were established more than 17 years ago by the American College of Rheumatology.  Almost one-third of patients participating in GfK’s research reported that it took two years or more of suffering symptoms before they visited a physician.  Furthermore, fibromyalgia patients visited almost three different physicians, on average, before a diagnosis was made, and almost one-third reported that the diagnosis was determined more than two years after the initial physician visit. 

Fibromyalgia patients report a much more wide-ranging set of symptoms when compared to more traditional neuropathic pain conditions.  These patients are more likely to describe their pain as "aching pain,” and more likely to report muscle spasms (64 percent of patients), tenderness (65 percent) and overly sensitive to touch (74 percent).  Compared to other neuropathic pain patients, a larger proportion of fibromyalgia patients report suffering from a host of nonpain symptoms: fatigue/tiredness (cited by 96 percent of fibromyalgia patients vs. 60 to 66 percent of patients with other pain conditions), sleeplessness/insomnia (78 percent vs. 44 to 60 percent for other conditions), feelings of depression (75 percent vs. 33 to 43 percent for other conditions) and headaches (57 percent vs. 23 to 36 percent for other conditions). 

As a result of the wide variety of symptoms experienced, fibromyalgia patients put a particular emphasis on a drug’s ability to "improve quality of life,” with 43 percent of fibromyalgia patients ranking it as a Top 3 attribute.

"Pain reduction will certainly improve quality of life to a degree, but given the range of nonpain symptoms experienced by fibromyalgia patients, marketers face a particular challenge in managing patients’ expectations of a drug’s effects across all symptoms,” said Geoff Penney, vice president and category business leader, neurology, GfK Market Measures.  "Especially in fibromyalgia, discontinuance might be influenced by patients’ disappointment that not all symptoms have been alleviated with their brand medication.  Therefore, a critical part of a brand’s marketing campaign should be patient support materials that serve to educate on how these other nonpain symptoms can be alleviated through additional medical services or treatments.”

In comparing the two medications with fibromyalgia indications – Cymbalta, which was approved last month, and Lyrica, which was approved in June 2007 – both seem to have very similar efficacy experiences reported by patients   (Cymbalta rated 4.50 and Lyrica rated 4.72 on a seven-point scale).  However, Cymbalta appears to hold an advantage in higher satisfaction ratings by patients for "whether it has significant side effects” (Cymbalta rated 4.71 and Lyrica rated 3.94 on a seven-point scale).  Similar to other pain conditions, fibromyalgia patients report high combination therapy use.  GfK’s research shows almost three-quarters of fibromyalgia patients using Lyrica or Cymbalta are also using a traditional analgesic medication (about 30 percent are using hydrocodone-acetaminophen).  Additionally, 20 percent of patients using Cymbalta report also using Lyrica.

More Than 900 Neuropathic Pain Patients Share Their Insights

Reflecting insights from 905 neuropathic pain patients including those diagnosed with diabetic neuropathic pain, fibromyalgia, neuropathic lower back pain and postherpetic neuralgia, fielded via Internet questionnaire in February 2008, GfK Market Measures’ 2008 Neuropathic Pain Patient Study provides a comprehensive analysis of the neuropathic pain market from the perspective of patients using prescription medication to treat their pain.