Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment

Womens Health Issues. Jan-Feb 2009;19(1):70-8. doi: 10.1016/j.whi.2008.07.002.

Abstract

Purpose: In this study, we sought to 1) describe elements of the financial and quality-of-life burden of dysfunctional uterine bleeding (DUB) from the perspective of women who agreed to obtain surgical treatment; 2) explore associations between DUB symptom characteristics and the financial and quality-of-life burden; 3) estimate the annual dollar value of the financial burden; and 4) estimate the most that could be spent on surgery to eliminate DUB symptoms for which medical treatment has been unsuccessful that would result in a $50,000/quality-adjusted life-year incremental cost-effectiveness ratio.

Methods: We collected baseline data on DUB symptoms and aspects of the financial and quality-of-life burden for 237 women agreeing to surgery for DUB in a randomized trial comparing hysterectomy with endometrial ablation. Measures included out-of-pocket pharmaceutical expenditures, excess expenditures on pads or tampons, the value of time missed from paid work and home management activities, and health utility. We used chi2 and t tests to assess the statistical significance of associations between DUB characteristics and the financial and quality-of-life burden. The annual financial burden was estimated.

Results: Pelvic pain and cramps were associated with activity limitations and tiredness was associated with a lower health utility. Excess pharmaceutical and pad and tampon costs were $333 per patient per year (95% confidence interval [CI], $263-$403). Excess paid work and home management loss costs were $2,291 per patient per year (95% CI, $1847-$2752). Effective surgical treatment costing $40,000 would be cost-effective compared with unsuccessful medical treatment.

Conclusion: The financial and quality-of-life effects of DUB represent a substantial burden.

Trial registration: ClinicalTrials.gov NCT00114088.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Confidence Intervals
  • Cost of Illness*
  • Cost-Benefit Analysis
  • Endometrial Ablation Techniques / economics*
  • Female
  • Humans
  • Hysterectomy / economics*
  • Metrorrhagia / economics*
  • Metrorrhagia / surgery*
  • Middle Aged
  • Odds Ratio
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Treatment Outcome
  • Women's Health / economics*

Associated data

  • ClinicalTrials.gov/NCT00114088