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Incremental direct and indirect costs of untreated vasomotor symptoms

Sarrel, Philip MD1; Portman, David MD2; Lefebvre, Patrick MA3; Lafeuille, Marie-Hélène MA3; Grittner, Amanda Melina MA3; Fortier, Jonathan MA3; Gravel, Jonathan MSc3; Duh, Mei Sheng MPH, ScD4; Aupperle, Peter M. MD, MPH5

doi: 10.1097/GME.0000000000000320
Original Articles

Objective Most women with moderate to severe vasomotor symptoms (VMS) are untreated. This retrospective matched-cohort study aims to evaluate the healthcare resource utilization, work loss, and cost burden associated with untreated VMS.

Methods Health insurance claims (1999-2011) were used to match (1:1) women with untreated VMS with control women using propensity score. Healthcare resource utilization, work productivity loss (disability + medically related absenteeism), and associated costs were compared between cohorts.

Results During the 12-month follow-up, women with untreated VMS (n = 252,273; mean age, 56 y) had significantly higher healthcare resource utilization than women in the control cohort: 82% higher for all-cause outpatient visits (95% CI, 81-83; P < 0.001) and 121% higher (95% CI, 118-124; P < 0.001) for VMS-related outpatient visits. Mean direct costs per patient per year were significantly higher for VMS women (direct cost difference, US$1,346; 95% CI, 1,249-1,449; P < 0.001). VMS women had 57% (95% CI, 51-63; P < 0.001) more indirect work productivity loss days than controls, corresponding to an incremental indirect cost per patient per year associated with untreated VMS of US$770 (95% CI, 726-816; P < 0.001).

Conclusions This study shows that untreated VMS are associated with significantly higher frequency of outpatient visits and incremental direct and indirect costs.

From the 1Departments of Obstetrics and Gynecology and Psychiatry, Yale University School of Medicine, New Haven, CT; 2Columbus Center for Women’s Health Research, Columbus, OH; 3Groupe d’analyse, Ltée, Montréal, QC, Canada; 4Analysis Group Inc, Boston, MA; and 5Noven Pharmaceuticals Inc, New York, NY.

Received April 25, 2014; revised and accepted July 3, 2014.

Funding/support: This study was supported by Noven Pharmaceuticals Inc.

Financial disclosure/conflicts of interest: P.S. is a paid consultant and speaker for Noven Pharmaceuticals Inc. D.P. is a paid consultant and speaker for Noven Pharmaceuticals Inc, Pfizer, and Shionogi; is a paid consultant for Shionogi and Sprout and Teva; and has received a grant from Endoceutics. P.L., M.-H.L., A.M.G., J.F., J.G., and M.S.D. are employees of Analysis Group Inc, a contract research organization that has received research grants from Noven Pharmaceuticals Inc. P.M.A. is an employee of Noven Pharmaceuticals Inc.

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Address correspondence to: Philip Sarrel, MD, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520. E-mail:

© 2015 by The North American Menopause Society.