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Direct and Indirect Costs of Women Diagnosed With Menopause Symptoms

Kleinman, Nathan L. PhD; Rohrbacker, Nicholas J. PhD; Bushmakin, Andrew G. MS; Whiteley, Jennifer EdD, MSc, MA; Lynch, Wendy D. PhD; Shah, Sonali N. RPh, MPH, MBA

Journal of Occupational and Environmental Medicine: April 2013 - Volume 55 - Issue 4 - p 465–470
doi: 10.1097/JOM.0b013e3182820515
Original Articles

Objective: To quantify employee burden of those diagnosed with menopause symptoms.

Methods: This regression-based study analyzed 2001-to-2010 medical, pharmacy, sick leave, disability, workers' compensation, and productivity data of large US employers. A cohort of employed women with diagnosed menopause symptoms (DMS), aged more than 40 years, were identified using medical claims International Classification of Diseases, Ninth Revision, Clinical Modification codes 627.xx. Control employees were propensity matched on age, employer, plan enrollment length, and enrollment end date.

Results: The study included 17,322 in each cohort. Employees with DMS had significantly higher medical ($4315 vs $2972, P < 0.001), pharmacy ($1366 vs $908, P < 0.001), sick leave costs ($647 vs $599, P < 0.001), and sick leave days (3.57 vs 3.30, P < 0.001). Employees with DMS had 12.2% (P = 0.007) lower hourly productivity and 10.9% (P = 0.014) lower annual productivity than controls.

Conclusions: Although all women experience menopause, women with DMS have significantly higher utilization and productivity burdens.

From the HCMS Group LLC (Dr Kleinman, Dr Rohrbacker, Ms Lynch), Cheyenne, Wis; WellPoint, Inc (Dr Rohrbacker), Indianapolis, Ind; and Pfizer Inc (Mr Bushmakin, Dr Whiteley, Ms Shah), New York, NY.

Address correspondence to: Nathan L. Kleinman, PhD, 415 W 17th Street, Suite 250, Cheyenne, WY 82001 (

This study was sponsored by Pfizer Inc. Nathan Kleinman, Nicholas Rohrbacker, and Wendy Lynch were employees of HCMS Group LLC, an affiliate of the Research and Education on Health as Human Capital Foundation, who were paid consultants to Pfizer in connection with the study and the development of this manuscript. Andrew Bushmakin, Jennifer Whiteley, and Sonali Shah are employees of Pfizer Inc.

©2013The American College of Occupational and Environmental Medicine