The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres

Steven Simoens, G.A.J. Dunselman, Gerard Dunselman, Carmen Dirksen, Carmen D. Dirksen, L. Hummelshoj, Lone Hummelshoj, Attila Bokor, Iris Brandes, Valentin Brodszky, Michel Canis, Giorgio Lorenzo Colombo, Thomas DeLeire, Tommaso Falcone, Barbara Graham, Gülden Halis, G Halis, Andrew Horne, Andrew W. Horne, O. Kanj, Omar Kanj, Jens Jørgen Kjer, Jens Kristensen, J. A. Kristensen, Dan Lebovic, Dan I. Lebovic, Michael Mueller, Michael D. Mueller, Paola Viganò, Paola Vigano, Marcel Wullschleger, Thomas D’Hooghe, Thomas D'Hooghe
Human Reproduction · 2012 · vol. 27(5) , pp. 1292–1299 · doi:10.1093/humrep/des073 · PMID:22422778 · W2145383112
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This study found that women with endometriosis treated in referral centers incurred high annual costs, primarily due to productivity loss, and that decreased quality of life predicted higher direct and total costs.

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Abstract

BACKGROUND: This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. METHODS: A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. RESULTS: Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. CONCLUSIONS: Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Health Care Costs Quality of Life Adult Ambulatory Care Cost of Illness Endometriosis Endometriosis Female Health Care Costs Humans Infertility, Female Infertility, Female Pelvic Pain Pelvic Pain Prospective Studies Quality-Adjusted Life Years Regression Analysis Tertiary Care Centers

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