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    The economics of uterine fibroids

    Costly to patients in more ways than one

    Having uterine fibroids can have a financial impact, both directly and indirectly, but the costs vary greatly by location, according to results of a new study. 

    A systematic literature review published in the August 2015 issue of AJOG summarized the direct costs (ie, involving diagnosis and treatment) and indirect costs (ie, involving lost wages and reduced productivity) per patient associated with uterine fibroids in 26 research studies that were published in the time period 2000–2013.

    See also: The MIGS approach to fixing failed endometrial ablation

    The researchers point out that more than 80% of black women and about 70% of white women in the United States will develop uterine fibroids by age 50. “Given the high prevalence of uterine fibroids,” they state, “the associated debilitating symptoms that affect daily activities and the invasiveness of treatment options, the economic burden of UF is considerable.” They site a study by Flynn et al. that estimated a total direct cost (including inpatient and outpatient care) of $3.5 billion in the United States (in 2013 USD).

    The 26 studies examined in the review included 19 in the United States, 2 in the Netherlands, 1 study each in Germany, China, Italy, and Canada, and one that collected statistics from 3 countries: Germany, France, and England.

    The researchers found that the total costs (the sum of direct and indirect costs) ranged from $11,717 to $25,023 per patient per year, after diagnosis or surgery among patients with uterine fibroids.

    Of course, surgical treatment comes with indirect costs due to recovery time. The researchers found these costs to be significant, ranging from $6210 per patient over 2 years after a uterine artery embolization in the Netherlands to $33,172 in 1 year after a hysterectomy in the United States.

    They note that more studies with longer data collection windows after the diagnosis of fibroids are needed to estimate the costs of re-treating patients with fibroid regrowth.

     

    Soliman AM et al. The direct and indirect costs of uterine fibroid tumors: a systematic review of the literature between 2000 and 2013. AJOG. August 2015; 141–160.

    Susan C. Olmstead
    Ms. Olmstead is the Editorial Director of Contemporary OB/GYN.

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