OBJECTIVES: To document surgical treatment patterns of uterine fibroid (UF) patients and total all-cause medical costs for UF patients in real-world practice settings using managed care claims data.
METHODS: In this retrospective database study, women with a UF diagnosis between 15 and 51 years of age were selected between 2000 and 2006. An index date was defined as the date of first observed UF diagnosis. All patients were required to have continuous plan enrollment 6 months pre- and 36 months post-index date. Summary statistics for patient characteristics, probability of first UF-related surgery, any repeat UF-related surgery, and total medical and pharmacy costs (2007 US$) incurred 12 months post-index date were generated.
RESULTS: A total of 109,595 patients met the study inclusion criteria. The mean age at UF diagnosis was 43 years and the mean Charlson score was 0.27. Patients with commercial insurance accounted for 91% of the population, while 75% had an HMO or PPO plan. The probability of UF-related surgery was 30.2%, 35.0%, and 38.4% within the 12-month, 24-month, and 36-month follow-up periods, respectively. Among patients with a UF-related surgery during the 36 month follow-up period, 79.6%, 7.3%, 3.3%, 13.0% had hysterectomy, myomectomy, UAE/UAO, and ablation, respectively. Mean age at first surgery (44 years) varied by surgery type with younger women more likely to undergo myomectomy. The rate of repeat surgery within one year of first surgery ranged from 1.6% (hysterectomy) to 10.5% (ablation). The mean total cost for all UF patients was $9608, 12 months post-index date.
CONCLUSIONS: A substantial proportion of patients undergo UF-related surgeries within one to three years of diagnosis, with hysterectomy being the most common surgery. UF-related surgeries present significant clinical and economic implications that should be understood by private and public third party payers who bear the financial burden of UF surgical care.
