Healthcare utilization and costs in women diagnosed with endometriosis before and after diagnosis A longitudinal analysis of claims databases

Endometriosis is associated with a substantial economic burden during the 5-year periods both before and after diagnosis; healthcare utilization and costs peak during the first year after diagnosis among endometriosis patients.


Mahesh Fuldeore, Ph.D., Hongbo Yang, Ph.D., Ella Xiaoyan Du, M.E.Sc., Ahmed M. Soliman, Ph.D., Eric Q. Wu, Ph.D., Craig Winkel, M.D.

Volume 103, Issue 1, Pages 163-171



To assess healthcare resource utilization and costs during the 5 years before and 5 years after diagnosis among women with endometriosis, in comparison with women without endometriosis.


Longitudinal, retrospective, case–control study.




A total of 37,570 matched pairs of women with and without (controls) endometriosis were identified from the Truven Health MarketScan claims database (2000–2010).



Main Outcome Measure(s):

Annual healthcare resource utilization and costs (in 2010 US dollars) were evaluated for the 5 years before and 5 years after diagnosis.


Mean patient age at index (first diagnosis) date was 36.4 years for endometriosis patients and controls. Endometriosis patients had a higher utilization of outpatient and emergency room services during each pre- and postindex year, and a higher utilization of inpatient services during the last preindex year and all 5 postindex years. Total costs were highest in the first postindex year for endometriosis patients, reaching $13,199, compared with $3,747 for controls. Annual costs were significantly higher for patients than controls during each pre- and postindex year; overall, the cost difference was $26,305 over 10 years: $7,028 in the 5 years before diagnosis and $19,277 in the 5 years after diagnosis.


Endometriosis poses a significantly high economic burden, both before and after diagnosis. The highest resource utilization and costs experienced by endometriosis patients occur in the first year after diagnosis.

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