State Level Treatment Differences in Heavy Menstrual Bleeding and Uterine Fibroids: Claims Analysis [33B

Abstract

INTRODUCTION: Heavy menstrual bleeding (HMB) is one of the most common and bothersome symptoms among women with uterine fibroids (UF). There is no published data to illustrate treatment differences by state and diagnosis of UF and/or HMB. METHODS: Retrospective study based on Truven MarketScan® Commercial Claims Database over the period 2007–2017. Women age 18–51 years were grouped into three cohorts upon diagnosis: a. UF only (ICD-9 218.x or ICD-10 D25.x); b. HMB only (ICD-9 626.2 or 627.0, ICD-10 N92.0, N92.1 or N92.4); c. UF and HMB. Treatment type (medical, surgical, no treatment) in the 12 months post-diagnosis was examined descriptively for each cohort and state. RESULTS: Study population included over one million women diagnosed with UF and/or HMB. During the 12 months post-diagnosis, about one-third of women with both UF and HMB were untreated. National surgery rate among diagnosed patients was 52% in those with UF and HMB, 20% in HMB only and 18% in UF only. At state level, surgery rate among UF and HMB diagnosed women ranged 31% - 79%; the five states with the highest surgery rates were all in the West/Midwest, and four out of the five states with the lowest surgery rates were in the Northeast. Hysterectomies represented 67% of all surgeries nationally in UF and HMB; 31 states had hysterectomy rates higher than the national average, 35% of them were in the South. CONCLUSION: Surgery rates were the highest among women with UF and HMB. Treatment differences among the states were substantial.