Abstract
Objectives
To determine in an eligible Utah Medicaid population (1) medical and drug costs associated with treating uterine fibroids (UFs) and (2) the cost and incidence of hysterectomy complications.
Methods
Medical and drug cost analyses were based on data from 897 premenopausal patients with UFs included in the Utah Medicaid database from 1996 to 2004. UF-related medical and pharmacy costs were determined from first diagnosis of UFs until a related procedure or until estimated menopause. Outcomes for patients treated with a procedure (hysterectomy, myomectomy, or embolization), medication, and watchful waiting (no procedure, no UF-related drug) were compared. When determining hysterectomy complication rates for the population of women in the Medicaid database, a total of 1,323 pre- or postmenopausal patients with UFs were included.
Results
Overall, 20% of patients were treated with medication, 33% with a procedure, and 47% with watchful waiting. Mean total UF costs were: $11,996 (procedure), $2,703 (medication), and $2,118 (watchful waiting). Mean eligibility months were 8.8, 28.8, and 14.1, respectively. Costs/eligible month were: $1,358 (procedure), $151 (watchful waiting), and $94 (medication). The mean hysterectomy cost was $12,107.
Conclusion
Treatment for UFs is expensive with a mean cost of $5,504 per study patient. The highest costs are seen in patients receiving procedures, which can lead to complications; 15% in this study. Costs for watchful waiting are similar to costs in patients receiving UF-related drugs. Consideration should be given to using non-surgical therapies for the treatment of UFs before procedures are performed.
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References
Becker ER, Spalding J, DuChane J, Jorowitz IR (2005) Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998–2002. J Natl Med Assoc 97(10):1336–1342
Broder M (2002) Uterine fibroids. In: Pregler JP, DeCherney AH (eds) Women’s health: principles and practice. BC Decker Inc., Ontario
Broder MS (2004) Gynecologic procedures. In: Hacker N, Moore JG, Gambone JG (eds) Essentials of gynecology, 4th edn. WB Saunders, New York
Broder MS, Spalding J (2006) Treatment patterns for women with new episodes of uterine myomas in an insured population in the US. Curr Med Res Opin 22:95–100
Carlson KJ, Miller BA, Fowler FJ Jr (1994) The Maine women’s health study: I. Outcomes of hysterectomy. Obstet Gynecol 83(4):556–565
Carlson KJ, Miller BA, Fowler FJ Jr (1994) The Maine women’s health study: II. Outcomes and nonsurgical management of leimyoma, abnormal bleeding, and chronic pelvic pain of hysterectomy. Obstet Gynecol 83(4):566–572
Doridot V, Dubuisson JB, Chapron C, Fauconnier A, Babaki-Fard K (2001) Recurrence of leiomyomata after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 8(4):495–500
EMedicine Consumer Health—Menopause overview (accessed 10/05/04). http://www.emedicinehealth.com/articles/6759-1.asp
Hakim RB, Benedict B, Merrick NJ (2004) Quality of care for women undergoing a hysterectomy: effects of insurance and race/ethnicity. Am J Public Health 94(8):1399–1405
Healthcare Cost and Utilization Project, AHRQ (accessed 2/5/06). http://hcup.ahrq.gov/HCUPnet.asp
Kaiser Commission on Medicaid and the Uninsured (accessed 1/11/06). http://www.kff.org/medicaid/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=33829
Keshavarz H, Jikis SD, Kicke BA, Marchbanks PA; Centers for Disease Control and Prevention (2002) Hysterectomy surveillance—United States, 1994–1999. MMWR 51(SS05):1–8
Kjerulff K, Langenberg P, Guzinski G (1993) The socioeconomic correlates of hysterectomies in the United States. Am J Public Health 83(1):106–108
Marshall LM, Spiegelman D, Barbieri RL, Goldman MB, Manson JE, Colditz GA et al (1997) Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol 90(6):967–973
National Pharmaceutical Council (2003) Pharmaceutical benefits under State Medical Assistance Programs. National Pharmaceutical Council Inc., Reston
National Uterine Fibroids Association (accessed 12/16/05). www.nuff.org/health.htm
Reuters Health (accessed 11/22/05). Uterine fibroids and hysterectomy, March 2002. http://www.reutershealth.com/wellconnected/doc73.html
Rowe MK, Kanouse DE, Mittman BS, Bernstein SJ (1993) Quality of life among women undergoing hysterectomies. Obstet Gynecol 93(6):915–921
Society of Interventional Radiology (accessed 11/22/05). Uterine fibroid treatment options. http://www.sirweb.org/patPub/uterineTreatments.html
Van Noord PAH et al (1997) Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. Fertil Steril 14:95–102
Acknowledgment
This project was funded by TAP Pharmaceutical Products Inc.
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Oderda, G., Asche, C., Jones, K.P. et al. Characterization of therapy and costs for patients with uterine fibroids in Utah Medicaid. Arch Gynecol Obstet 276, 211–218 (2007). https://doi.org/10.1007/s00404-007-0332-6
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DOI: https://doi.org/10.1007/s00404-007-0332-6