J Clin Outcomes Manage
Heavy menstrual bleeding treatment patterns and associate health care utilization and costs
Copher R, Nestour EL, Zampaglione E, Prezioso AN, Pocoski J, Law A
ABSTRACT Objective: To evaluate health care resource utilization and costs associated with heavy menstrual bleeding (HMB) treatment and to compare outcomes between patients without an identified underlying condition (idiopathic HMB) and patients with an identified cause (organic HMB). Design: Retrospective claims analysis. Participants: Commercially insured female enrollees aged 18-49 years with newly diagnosed HMB. Measurements: The index date was the first claim date with an HMB diagnosis; patients were followed from 6 months prior to index date (pre-index period) to 18 months following index date (post-index period). Treatment patterns, health care resource utilization, and cost outcomes were evaluated post-index and stratified by cohort and age-group. Variables were descriptively analyzed with comparisons across cohorts. Results: Newly diagnosed HMB patients (n = 34,941; mean age 40.5 years) included 21,362 idiopathic and 13,579 organic HMB patients. Among idiopathic HMB patients, over 30% did not receive any evaluated treatments; 68.8% received at least 1 treatment episode (57.6% received only 1 treatment episode and 10.9% only 2). More than half (55.7%) underwent surgery as their initial treatment. Among single-episode treatments, hysterectomy was associated with the highest HMB-related costs for both cohorts (idiopathic: mean $9089 [SD $5940], median $8493; organic: mean $9395 [SD $6291], median $8634). GLM analysis revealed predicted HMB-related costs of $3858.59 for the idiopathic cohort and $5788.64 for the organic cohort. Conclusions: HMB is associated with increased health care resource utilization and costs.
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