Annual Costs Associated With Diagnosis of Uterine Leiomyomata

Hartmann, Katherine E. MD, PhD1; Birnbaum, Howard PhD2; Ben-Hamadi, Rym MSc2; Wu, Eric Q. PhD2; Farrell, Max H.2; Spalding, James PharmD, MS3; Stang, Paul PhD4

doi: 10.1097/01.AOG.0000234651.41000.58
Original Research

OBJECTIVE: To describe the annual care, direct health care, and indirect work loss costs for women with a diagnosis of uterine leiomyomata.

METHODS: We examined data from an employer claims database of 1.2 million beneficiaries (1999 to 2003). Analysis was restricted to women with at least 12 months of continuous coverage and ages 18 to 64 years with at least one diagnosis of leiomyomata (International Classification of Diseases, 9th Revision, 218.xx, 654.1x). We selected a comparison group of women without a leiomyoma diagnosis using a 1:1 match on age, employment, region, health plan type, and length of enrollment. We compared resource use, disability claims, and excess costs in the year after the index diagnosis.

RESULTS: The average age of women diagnosed with leiomyomata in this study was 43.7 years. Women with leiomyomata (N=5,122) had more clinic visits (relative risk [RR] 1.2, 95% confidence interval [CI] 1.2–1.2), diagnostic tests (RR 3.1, 95% CI 2.9–3.2), and procedures (RR 34.6, 95% CI 25.8–46.5) than controls (N=5,122). Within 1 year of the diagnosis of leiomyomata, 42% of women had a complete blood count, 66% had pelvic imaging, and 30% had surgery (68% of surgical procedures involved hysterectomy). Women with leiomyomata were 3-fold more likely to have disability claims (RR 3.1, 95% CI 2.7–3.6). Estimated average annual excess cost for each woman with leiomyomata (adjusted for confounders) was $4,624 ($771 in work loss costs). Total costs for women with leiomyomata were 2.6 times greater than for controls.

CONCLUSION: Diagnosed uterine leiomyomata are associated with increased resource use and with substantially higher health care and work loss costs.

LEVEL OF EVIDENCE: II-3

Uterine leiomyomata are associated with increased use of resources and with substantially higher health care and work loss costs.

From the 1Center for Women’s Health Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; 2Analysis Group Inc, Boston, Massachusetts; 3TAP Pharmaceutical Products Inc, Lake Forest, Illinois; 4West Chester University, West Chester, Pennsylvania.

Corresponding author: Katherine E. Hartmann, MD, PhD, Center for Women’s Health Research, University of North Carolina, Chapel Hill, NC 27599-7521; e-mail: khartman@med.unc.edu.

Financial Disclosure This research was funded by TAP Pharmaceutical Products Inc, Lake Forest, Illinois. Drs. Birnbaum, Ben-Hamadi, Wu, and Farrell are employees of Analysis Group Inc. Dr. Spalding is an employee of TAP Pharmaceutical Products Inc.

© 2006 The American College of Obstetricians and Gynecologists