PIH20 A TARGETED LITERATURE REVIEW OF THE ECONOMIC BURDEN ASSOCIATED WITH POLYCYSTIC OVARY SYNDROME

Abstract

Listen

Translate article

To collate published economic evidence on the cost and resource utilisation associated with polycystic ovary syndrome (PCOS). A literature search was conducted in Embase® and MEDLINE® to identify evidence published from 2009 to 2019. Conference proceedings and bibliographies were also searched. Retrieved studies were included if they were published in English and reported economic burden associated with PCOS. Of the 1079 publications retrieved, six studies were included. One Australian study reported fertility hormone treatment in 33% of PCOS women (Joham et al., 2015). The other – a population-based retrospective cohort study in Australia– reported higher hospitalisation rates for treating gynaecological conditions in PCOS women than in non-PCOS women. Most PCOS women had one hospital admission (77.7%); 12.8% had two admissions and 9.5% had at least three (Hart et al., 2015). In Hungary, the annual health insurance cost of PCOS was HUF78.9 million (€281,160) in 2009 (Boncz et al., 2013). The annual healthcare burden of PCOS associated with type 2 diabetes was at least £237 million in a UK based Bayesian modelling study (Ding et al., 2018). In a randomised study conducted in the Netherlands, the mean cost per first live birth for PCOS women was significantly lower when electrocautery was used to treat clomiphene-resistant PCOS women (€11,176; 95% confidence interval [CI]: €9,689–€12,549) than when recombinant follicle-stimulating hormone was used (€14,423; 95% CI: €12,239–€16,606) (Nahuis et al., 2012). An exogenous low-dose highly purified urinary follicle-stimulating hormone (HP uFSH) step-up protocol with co-administration of clomiphene was cost effective than a low dose step-up HP uFSH protocol in clomiphene-resistant PCOS women (cost-effective ratio: 523 versus 5,236) (Al Boghdady et al., 2012). PCOS is associated with a high economic burden globally. The major contributing factors are infertility, use of fertility hormone treatment, and hospitalisation.