Direct medical cost of pelvic inflammatory disease and its sequelae: decreasing, but still substantial

Obstet Gynecol. 2000 Mar;95(3):397-402. doi: 10.1016/s0029-7844(99)00551-7.


Objective: To estimate direct medical costs and average lifetime cost per case of pelvic inflammatory disease (PID).

Methods: We estimated the direct medical expenditures for PID and its three major sequelae (chronic pelvic pain, ectopic pregnancy, and infertility) and determined the average lifetime cost of a case of PID and its sequelae. We analyzed 3 years of claims data of privately insured individuals to determine costs, and 3 years of national survey data to determine number of cases of PID, chronic pelvic pain, and ectopic pregnancy. We developed a probability model to determine the average lifetime cost of a case of PID.

Results: Direct medical expenditures for PID and its sequelae were estimated at $1.88 billion in 1998: $1.06 billion for PID, $166 million for chronic pelvic pain, $295 million for ectopic pregnancy, and $360 million for infertility associated with PID. The expected lifetime cost of a case of PID was $1167 in 1998 dollars. The majority of those costs ($843 per case) represent care for acute PID rather than diagnosis and treatment of sequelae. Approximately 73% of cases will not accrue costs beyond the treatment of acute PID.

Conclusion: The direct medical cost of PID is still substantial. The majority of PID related costs are incurred in the treatment of acute PID. Because most PID-related costs arise in the first year from treatment of acute PID infection, strategies that prevent PID are likely to be cost-effective within a single year.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cost of Illness
  • Female
  • Health Expenditures*
  • Humans
  • Infertility, Female / economics
  • Models, Statistical
  • Pelvic Inflammatory Disease / economics*
  • Pelvic Pain / economics
  • Pregnancy
  • Pregnancy, Ectopic / economics
  • United States