Treatment patterns and healthcare resource utilization and costs in heavy menstrual bleeding: a Japanese claims database analysis

Abstract

Aims: Heavy menstrual bleeding (HMB) is a highly prevalent condition, characterized by excessive menstrual blood loss and cramping, that interferes with activities of daily life. The aim of this study was to investigate treatment patterns in HMB in Japan, and to assess healthcare resource utilization and costs among women newly-diagnosed with the condition.

Materials and methods: This study retrospectively analyzed health insurance data available in the Japan Medical Data Center (JMDC) database on women aged 18–49 years who were newly-diagnosed with primary or secondary HMB. Treatment patterns were analyzed, and healthcare utilization and costs were evaluated and compared to matched controls.

Results: The study included a total of 635 patients, 210 with primary HMB and 425 with secondary HMB. In the primary HMB cohort, 60.0% of patients received one or more pharmacological or surgical treatments, compared with 76.2% in the secondary HMB cohort. The most commonly prescribed medications in all patients were hemostatic agents (28.7%), traditional Chinese medicine (TCM) (12.1%), and low-dose estrogen progestins (LEPs) (10.1%). After adjustment for patient baseline characteristics, healthcare costs were 1.93-times higher in primary HMB cases (p < .0001) and 4.44-times higher in secondary HMB cases (p < .0001) vs healthy controls. Outpatient care was the main cost driver.

Limitations: The main limitations of this study are related to its retrospective nature, and the fact that only reimbursed medications were captured in the source database.

Conclusions: A substantial proportion of HMB patients did not receive the recommended treatments. Healthcare costs were considerably increased in the presence of an HMB diagnosis.

Keywords:

• Administrative claims database
• Healthcare costs
• Healthcare resource
• Heavy menstrual bleeding
• Menorrhagia
• Prescribing patterns
• Real-world data

JEL classification codes:

• I10
• I19

Transparency

Declaration of funding

This study was funded by Bayer Yakuhin, Ltd.

Declaration of financial/other relationships

SA and ET are employees of Bayer Yakuhin, Ltd. OC and YOn are employees from Creativ-Ceutical, which received funding from Bayer Yakuhin, Ltd. YOs has received funding from Bayer Yakuhin, Ltd during the conduct of the study and outside the study from Bayer Yakuhin, Ltd; Fuji Pharma Co., Ltd; Mochida Pharmaceutical Co., Ltd; Nippon Shinyaku Co., Ltd; and Takeda Pharmaceutical Co., Ltd. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the manuscript. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to thank Bruno Rossi, a former employee of Bayer Yakuhin, Ltd, for his contribution to the planning of this research and for his review of the manuscript. The authors also wish to thank Marcia Reinhart for medical writing support. The results of this study have not been published previously.

Notice of Correction

Please note that the zip code of the corresponding author has been amended since the article was first published online (1 June 2018).