Burden of Heavy Menstrual Bleeding Associated with Uterine Fibroids: A Retrospective Analysis of a U.S. Medicaid Population

Abstract

Study Objective Assess healthcare costs in Medicaid women diagnosed with uterine fibroids (UF) and/or heavy menstrual bleeding (HMB). Design Retrospective claims analysis. Study period: January 1, 2007 - December 31, 2017. Setting IBM® MarketScan® Multi-State Medicaid Database. Patients or Participants Women age 18-51 years were grouped into four cohorts based upon diagnosis: (a) UF only (ICD-9 218.x or ICD-10 D25.x), (b) HMB only (ICD-9 626.2 or 627.0, or ICD-10 N92.0, N92.1 or N92.4), (c) UF+HMB, and (d) controls. Cohorts were matched based upon age, race, insurance type, and Charlson Comorbidity Index. Patient and treatments characteristics at baseline (1 year pre diagnosis) and follow-up (1 year post diagnosis) were examined descriptively, differences in follow-up costs were examined using analysis of variance. Interventions N/A. Measurements and Main Results After matching, study population included 16,691 women in each cohort, with mean age of 38 years and 54% black. In the matched cohorts, a higher percentage of women with UF+HMB were diagnosed with anemia at baseline (31%), compared to women with UF only (14%) or HMB only (19%). During follow-up, 41% of the UF+HMB cohort were treated surgically, compared to 14% of women with UF only and 15% with HMB only. Among women treated surgically, 74%, 83%, and 44% of the UF+HMB, UF only, and HMB only cohorts, respectively, had a hysterectomy. Mean all-cause total healthcare costs in the UF+HMB cohort ($11,310) were significantly higher compared to costs for all other cohorts ($9,400 UF only; $9,308 HMB only; $7,255 controls; all P Conclusion Women enrolled in Medicaid and diagnosed with UF+HMB are more frequently treated surgically and have significantly higher total healthcare costs compared to women with UF only, HMB only, or controls.