Healthcare utilization and costs among women diagnosed with uterine fibroids: a longitudinal evaluation for 5 years pre- and post-diagnosis

Abstract

Objective:

To evaluate the healthcare utilization, treatments, and costs incurred by women with uterine fibroids (UF), compared to those without UF, for 5 years before and 5 years after diagnosis.

Research design and methods:

This is a longitudinal, retrospective case–control study. A total of 84,954 women with a diagnosis of UF, along with matched controls of women without UF, were selected from the Truven Health MarketScan claims database (2000–2010). The date of diagnosis of the UF patient was assigned as the index date for both the UF patient and her matched control.

Main outcome measures:

Healthcare resource utilization, treatments, and costs (in 2010 USD) were evaluated annually for the 5 year periods before and after the index date.

Results:

UF patients had more outpatient and emergency room visits than controls before diagnosis, and more inpatient, outpatient, and emergency room visits than controls after diagnosis. Annual total healthcare costs were significantly higher for patients than controls during the last 3 years pre-index and all 5 years post-index. Overall, the difference was $12,623 over 10 years, with a difference of $1435 in the 5 years pre-diagnosis and a difference of $11,188 in the 5 years post-diagnosis. The cost difference between UF patients and controls was highest in the first year post-diagnosis, reaching $6131, and the difference was even larger when comparing clinically symptomatic UF patients to controls. The use of medications and surgical procedures related to UF peaked in the year post-diagnosis, with 39% of patients receiving a surgical treatment within the year.

Key limitations:

UF patients included in the study did not include undiagnosed and potentially asymptomatic UF patients; the impact of disease severity on the costs of UF patients was not evaluated.

Conclusions:

Patients with UF incurred significantly higher healthcare utilization and costs than those without UF, both pre- and post-diagnosis.

Keywords: :

• Cost
• Economic burden
• Healthcare resource utilization
• Leiomyomata
• Uterine fibroids

Transparency

Declaration of funding

This study was funded by AbbVie, which also develops the endometriosis and uterine fibroids drug Elagolix (in collaboration with Neurocrine Biosciences).

All authors participated in data analysis and interpretation, and contributed to the development of the manuscript. The authors maintained control over the final contents of the manuscript and the decision to publish in Current Medical Research and Opinion.

Declaration of financial/other relationships

M.F. and A.M.S. have disclosed that they are employees of AbbVie and may own AbbVie stock or stock options. H.Y. has disclosed that he is an employee of Analysis Group Inc., which has received consultancy fees from AbbVie. C.W. has disclosed that he is a Clinical Professor in the Department of Obstetrics and Gynecology at Georgetown University in Washington, DC, and has served in a consulting role to AbbVie for this project.

Peer reviewer 1 has disclosed that her employer has received funding for research she worked on from AbbVie in another therapeutic area. Peer reviewer 2 has no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank Ana Bozas PhD and Ella Xiaoyan Du MESc, employees of Analysis Group Inc., for their contributions to the preparation and editing of the manuscript.

Previous presentation: A synopsis of the current research was presented in poster format at the 2014 American Society for Reproductive Medicine (ASRM) annual meeting, Honolulu, HI, USA, 18–22 October 2014; and ISPOR 20th Annual International Meeting, Philadelphia, PA, USA, 16–20 May 2015.