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

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

Author information

1
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. kfrick@jhsph.edu

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.

PMID:
19111789
DOI:
10.1016/j.whi.2008.07.002
[Indexed for MEDLINE]

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