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Title: Health economics of endometriosis
Authors: D'Hooghe, Thomas
Vodolazkaia, A
Kyama, C
Mwenda, JM
Simoens, Steven
Issue Date: 2008
Publisher: Blackwell Publishing
Host Document: Endometriosis 2008 edition:First edition pages:1-16
Abstract: Background: Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction and is associated with pain, subfertility and impaired quality of life. The condition is found mainly in women of reproductive age, from all ethnic and social groups. The estimated prevalence of the disease is 10% among women of reproductive age making it more common than diabetes in this population
Objective: The aim of this chapter is to describe the overall economic impact of endometriosis including both direct costs associated with specific diagnosis and treatment and indirect costs associated with reduced work productivity, loss in earned income, social withdrawal, relational stress and psychological disorders such as depression.
Methodology: This review is based mainly on the content of 2 systematic reviews evaluating the economic impact of endometriosis (Gao et al, 2006; Simoens et al, 2007) and on a recently published actuarial analysis of private payer administrative claims data for women with endometriosis (Mirkin et al, 2007).
Results: Direct endometriosis-related costs are considerable, appear to be driven by hospitalizations, and have increased with 61% between 1993 and 2002 in the USA, despite a decline in the endometriosis-related hospital length of stay during the same period. Studies evaluating the cost of endometriosis in infertile patients and the indirect endometriosis-associated costs are largely lacking. Assuming a 10% prevalence rate of endometriosis among women of reproductive age, it has been estimated that the annual costs of endometriosis attained $22 billion in the USA only in 2002. In this age group, these costs are considerably higher than those related to Crohn’s disease, migraine, hypertension and comparable to the cost of diabetes. Furthermore, endometriosis-related costs are increasing, in contrast with the decreasing direct costs associated with PID. Due to the added cost related to comorbid conditions like interstitial cystitis, depression, migraine, irritable bowel syndrome, chronic fatigue syndrome, abdominal pain and infertility, women with endometriosis incurred total direct medical costs that were, on average, 63% higher than medical costs for the average women in a commercially insured group in the USA in 2004.
Conclusion and future perspectives: Endometriosis has an important economic impact, but the methodological value of the few existing cost studies is limited. The following recommendations can be made for future research regarding the cost of endometriosis: distinction between the disease endometriosis and the associated symptoms pain and infertility; differentiation of cost according to various degrees of endometriosis, cost related to endometriosis in adolescents; prospective longitudinal follow-up study of patients from the moment of diagnosis up till menopause including cost of complications, recurrences, ambulatory care, medication,… ; calculation of indirect cost related to endometriosis (loss of work,…); prospective collection of primary data on actual healthcare resource use by endometriosis patients on a national and an international level, based on a well defined list of the major cost items and of comorbid conditions.
ISBN: 978-1-4443-3213-1
VABB publication type: VABB-4
Publication status: published
KU Leuven publication type: IHb
Appears in Collections:Research Centre for Pharmaceutical Care and Pharmaco-economics (-)
Assisted Reproductive Technology Laboratory (-)

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