Healthcare resource utilization and costs among women diagnosed with uterine fibroids compared to women without uterine fibroids

Abstract

Objective: To perform a retrospective, matched-cohort, longitudinal evaluation of annual pre- and post-diagnosis costs incurred among women with uterine fibroids (UF) (cases) compared to controls without UF.

Methods: Data were derived from the IBM Watson Health MarketScan Commercial Claims and Encounters and Medicaid Multi-State databases. Women aged 18–64 years with ≥1 inpatient or outpatient medical claim with an initial UF diagnosis (index date) from 1 January 2010 to 31 December 2014 were included. Healthcare resource utilization (HCRU) data including pharmacy, outpatient and inpatient hospital claims were collected for 1 year pre-index and ≤5 years post-index. All-cause costs (adjusted to 2017 $US) were compared between cases and controls using multivariable regression models.

Results: Analysis included 205,098 (Commercial) and 24,755 (Medicaid) case–control pairs. HCRU and total all-cause healthcare costs were higher for cases versus controls during the pre-index year and all years post-index. Total unadjusted mean all-cause costs were $1197 higher (p < .0001; Commercial) and $2813 higher (standardized difference 0.08; Medicaid) for cases during the pre-index year. Total adjusted mean all-cause costs in the first year post-index were $14,917 for cases versus $5717 for controls in the Commercial population, and $20,244 versus $10,544, respectively, in the Medicaid population. In Years 2–5 post-index, incremental mean adjusted total costs decreased, but remained significantly higher for cases versus controls at all time points in both populations (all p < .05).

Conclusions: Costs were higher for women with UF compared to women without UF during the pre-index year and over 5 years post-index; differences were greatest in the first year post-index.

Keywords:

• Cost
• economic burden
• healthcare resource utilization
• leiomyomata
• uterine fibroids

Transparency

Declaration of funding

These analyses were funded by Allergan plc, Dublin, Ireland. Allergan (the sponsor) played a role in the study design, conduct, analysis, interpretation, writing of the report and decision to publish this analysis.

Author contributions

V.S., N.G.B., A.H. and P.G. were involved in the conception and design of the study. D.S.M. and R.M.F. designed the analytic approach. B.Y. and J.M.Y. analyzed the data. V.S., E.B., N.G.B., A.H., D.S.M., R.M.F. and P.G. were involved in interpretation of the data. All authors were involved in drafting the manuscript and in the critical revisions for intellectual content, and all authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work.

Declaration of financial/other relationships

V.S., N.G.B. and P.G. have disclosed that they are employees of Allergan plc and have stock, stock options and/or restricted stock units as employees of Allergan plc. A.H. and J.M.Y. have disclosed that they are employees of Allergan plc. No potential conflict of interest was reported by E.B. D.S.M. and B.Y. have disclosed that they are employees of Xcenda LLC. R.M.F. has disclosed that she is an employee of Astellas Pharma US Inc. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

Writing and editorial assistance was provided to the authors by Tracey Lonergan PhD, on behalf of Complete HealthVizion, and by Laura Gibbons PhD of Complete HealthVizion, and funded by Allergan plc, Dublin, Ireland. All authors met the ICMJE authorship criteria. Neither honoraria nor payments were made for authorship.

Data availability statement

Allergan will share de-identified patient-level data and study-level data including protocols and clinical study reports for phase II–IV trials completed after 2008 that are registered to ClinicalTrials.gov or EudraCT, have received regulatory approval in the United States and/or the European Union in a given indication, and the primary manuscript from the trial has been published. To request access to the data, the researcher must sign a data-use agreement and any shared data are to be used for non-commercial purposes. More information can be found at http://www.allerganclinicaltrials.com/.

Presented in part as a poster presentation at The AMCP Managed Care & Specialty Pharmacy Annual Meeting; 2018 Apr 23–26; Boston, MA, USA.