Incremental direct and indirect cost burden attributed to endometriosis surgeries in the United States

Ahmed M. Soliman, Hugh S. Taylor, Bonafede M, Machaon Bonafede, Nelson JK, James K. Nelson, Jane Castelli‐Haley, Jane Castelli-Haley, Castelli-Haley J
Fertility and sterility · 2017 · vol. 107(5) , pp. 1181–1190.e2 · doi:10.1016/j.fertnstert.2017.03.020 · PMID:28476181 · W2610640540
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This study quantified the incremental direct and indirect costs associated with endometriosis surgeries in the United States.

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Abstract

ObjectiveTo compare direct and indirect costs between endometriosis patients who underwent endometriosis-related surgery (surgery cohort) and those who have not received surgery (no-surgery cohort).DesignRetrospective cohort study.SettingNot applicable.Patient(s)Endometriosis patients (aged 18-49 years) with (n = 124,530) or without (n = 37,106) a claim for endometriosis-related surgery were identified from the Truven Health MarketScan Commercial and Health and Productivity Management databases for 2006-2014.Intervention(s)Not applicable.Main outcome measure(s)Primary outcomes were healthcare utilization during 12-month pre- and post-index periods, annual direct (healthcare) and indirect (absenteeism and short- and long-term disability) costs during the 12-month post-index period (in 2014 US dollars). Indirect costs were assessed for patients with available productivity data.Result(s)Patients in the surgery cohort had significantly higher healthcare resource utilization during the post-index period and had mean annual total adjusted post-index direct costs approximately three times the costs among patients in the no-surgery cohort ($19,203 [SD $7,133] vs. $6,365 [SD $2,364]; average incremental annual direct cost = $12,838). The mean cost of surgery ($7,268 [SD $7,975]) was the single largest contributor to incremental annual direct cost. Mean estimated annual total indirect costs were $8,843 (surgery cohort) vs. $5,603 (no-surgery cohort); average incremental annual indirect cost = $3,240.Conclusion(s)Endometriosis patients who underwent surgery, compared with endometriosis patients who did not, incurred significantly higher direct costs due to healthcare utilization and indirect costs due to absenteeism or short-term disability. Regardless of the surgery type, the cost of index surgery contributed substantially to the total healthcare expenditure.

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Condition tags

endometriosis

MeSH descriptors

Cost of Illness Endometriosis Endometriosis Health Care Costs Income Absenteeism Adolescent Adult Cohort Studies Direct Service Costs Direct Service Costs Endometriosis Endometriosis Female Health Care Costs Humans Income Middle Aged Prevalence Retrospective Studies

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