The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey

Mike Armour, Kenny Lawson, Aidan Wood, Caroline A Smith, Caroline Smith, Jason Abbott
PloS one · 2019 · vol. 14(10) , pp. e0223316 · doi:10.1371/journal.pone.0223316 · PMID:31600241 · W2979960321
article OA: gold CC0 ⤵ 142 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This Australian survey found that chronic pelvic pain, with or without endometriosis, significantly burdens the economy, primarily due to productivity loss, which increases substantially with pain severity.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This national online survey and cost-of-illness analysis used the retrospective patient component of the WERF EndoCost tool to quantify one-year direct healthcare costs, direct non-healthcare carer costs, and indirect productivity losses among 407 Australian women aged 18–45 with either surgically confirmed endometriosis (n=340) or chronic pelvic pain without a current endometriosis diagnosis (n=67). Costs were extrapolated to the Australian reproductive-aged population using published prevalence estimates, and sensitivity analyses varied productivity assumptions, unit costs, and prevalence, with results reported in international dollars. The key finding was that economic burden was substantial in both groups, with the majority (75–84%) driven by productivity loss; pain severity showed the strongest relationship to productivity costs, with reported costs increasing up to a 12.5-fold difference from minimal to severe pain. Relevance to endometriosis: the study directly measures the cost burden of endometriosis and also compares it to non-endometriosis chronic pelvic pain in the Australian context.

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Abstract

INTRODUCTION: Endometriosis has a significant cost of illness burden in Europe, UK and the USA, with the majority of costs coming from reductions in productivity. However, information is scarce on if there is a differing impact between endometriosis and other causes of chronic pelvic pain, and if there are modifiable factors, such as pain severity, that may be significant contributors to the overall burden. METHODS: An online survey was hosted by SurveyMonkey and the link was active between February to April 2017. Women aged 18-45, currently living in Australia, who had either a confirmed diagnosis of endometriosis via laparoscopy or chronic pelvic pain without a diagnosis of endometriosis were included. The retrospective component of the WERF EndoCost tool was used to determine direct healthcare costs, direct non-healthcare costs (carers) and indirect costs due to productivity loss. Estimates were extrapolated to the Australian population using published prevalence estimates. RESULTS: 407 valid responses were received. The cost of illness burden was significant in women with chronic pelvic pain (Int $16,970 to $ 20,898 per woman per year) irrespective of whether they had a diagnosis of endometriosis. The majority of costs (75-84%) were due to productivity loss. Both absolute and relative productivity costs in Australia were higher than previous estimates based on data from Europe, UK and USA. Pain scores showed the strongest relationship to productivity costs, a 12.5-fold increase in costs between minimal to severe pain. The total economic burden per year in Australia in the reproductive aged population (at 10% prevalence) was 6.50 billion Int $. CONCLUSION: Similar to studies in European, British and American populations, productivity costs are the greatest contributor to overall costs. Given pain is the most significant contributor, priority should be given to improving pain control in women with pelvic pain.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Chronic Pain Cost of Illness Endometriosis Internet Pelvic Pain Surveys and Questionnaires Adolescent Adult Australia Australia Chronic Pain Endometriosis Endometriosis Female Humans Pelvic Pain Severity of Illness Index Young Adult

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