Healthcare utilization and cost burden among women with endometriosis by opioid prescription status in the first year after diagnosis: a retrospective claims database analysis

Sawsan As‐Sanie, S As-Sanie, Ahmed M. Soliman, A M Soliman, Kathryn Evans, K Evans, Nathalie Erpelding, N Erpelding, R Lanier, Ryan K. Lanier, N P Katz, N. Katz
Journal of medical economics · 2019 · vol. 23(4) , pp. 371–377 · doi:10.1080/13696998.2019.1707212 · PMID:31856613 · W2995123615
article OA: bronze CC0 ⤵ 16 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that women with endometriosis who filled an opioid prescription within one year of diagnosis had significantly higher healthcare costs and utilization compared to those who did not.

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Abstract

Aims: Opioids do not represent standard therapy for endometriosis; however, women with endometriosis are frequently prescribed an opioid to manage related abdominal or pelvic pain. The aim of this study was to evaluate the impact of opioid use on endometriosis-related economic and healthcare burden in the United States.Materials and methods: We performed a retrospective, propensity-matched cohort analysis of the Truven MarketScan Commercial database from 1 January 2011 to 31 December 2016. Eligible women had at least 1 inpatient or 2 outpatient codes for endometriosis and 12 months of continuous enrollment before and after the index date (i.e. first recorded endometriosis diagnosis). The primary analysis examined healthcare costs and utilization for 12 months after the index date in women who filled at least 1 opioid prescription versus those who did not. The secondary analysis examined healthcare costs and utilization by the pattern of opioid use.Results: The primary analysis matched 43,516 women across 2 groups and the secondary analysis matched 13,230 women across 5 groups. In the primary analysis, total 12-month healthcare costs were significantly higher in the opioid group compared to the non-opioid group ($29,236.00 vs. $18,466.00, respectively; p < .001); the same pattern was observed for all healthcare utilization parameters. In the secondary analysis, higher morphine equivalent daily dose and proportion of days covered were associated with the highest healthcare costs and utilization compared to the non-opioid group.Limitations: Retrospective design and inability to confirm whether filled opioid prescriptions were actually taken.Conclusions: Filling an opioid prescription within 1 year after an endometriosis diagnosis was associated with significant excess healthcare burden. Patients prescribed an opioid may experience inadequate symptom management and benefit from the use of disease-specific, non-opioid therapies.

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Condition tags

endometriosis

MeSH descriptors

Analgesics, Opioid Cost of Illness Endometriosis Endometriosis Health Care Costs Patient Acceptance of Health Care Patient Acceptance of Health Care Adolescent Adult Analgesics, Opioid Databases, Factual Endometriosis Female Humans Insurance Claim Review Middle Aged Pain Management Retrospective Studies Young Adult

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