I’m James Segars with the Program in Reproductive and Adult Endocrinology with the National Institute of Child Health and Human Development. I’ll talk today on our recent report on the economic cost of uterine fibroids. Uterine fibroids are the most common disorder of women. One in two women will develop fibroids prior to the menopause. Specifically studies have shown that fifty percent of white women and eighty percent of black women will develop uterine fibroids. And about one percent of these women will seek care and treatment for uterine fibroids each year.
Fibroids effect the uterus or womb. This slide shows a fibroid removed at myomectomy and as you can see the tumors grow to be quite large, twelve centimeters, as shown by the ruler on the right. Fibroids cause pain, bleeding, and pelvic pressure. Because of their largesize and their symptoms many women require treatment. There are approximately thirtythousand myomectomies and 200,000 hysterectomies performed each year in the United States because of uterine fibroids. uh. As you can see here because of differences in disease severity and prevalence black women are much more likely to undergo these procedures.
Than white women. It’s also important to note that fibroids effect women who are building their families and becoming pregnant. This slide shows the prevalence of fibroids in women of reproductive age, age twenty to forty years old. Again note that fibroids are more prevalent in black than white women. Because of their involvement in the uterus during pregnancy there is a significant increase in the number of obstetric complications due to uterine fibroids. For example caesarean section is increased several fold in women who have fibroids of the uterus during pregnancy.
The Economic Cost of Uterine Fibroids
Again there are other complications as well as shown on this slide. While there have been several studies that have assessed the societal cost of uterine fibroids, no studies have previously examined the associated obstetrical cost of uterine fibroids on an annual basis. Therefore the goal of our study was to estimate the annual cost of uterine fibroids including obstetricrelated cost and pregnancyrelated costs as well as direct and indirect cost. We used available published data sources to estimate the annual cost of uterine fibroids and our analysis was based on the assumption that.
Point ninetytwo percent of women aged twenty five to forty would seek treatment during the year and approximately ninetyfour percent of those women would undergo treatment during that one year. The key points and figures are shown this slide. The point estimates were broad because the sources we used to estimate the range reported wide differences in cost. We converted all dollars to 2010 dollars and these estimates, of course, illustrate the fact that uterine fibroids result in a considerable expense to the United States health care system. Some noteworthy points are that pregnancy.
Related costs range from point two to seven point seven billion dollars a year. The largest contributor was lost work which is one point five to seventeen point two billion dollars per year. And the annual direct costs, which include surgery medical treatment hospitalization and outpatient treatment, was four point one to nine point one billion dollars per year. And the total cost due to uterine fibroids we estimated to be five point eight to thirty four point four billion dollars per year. While our study was a cost estimate it’s interesting to compare these estimates.
With other diseases that affect women and their associated cost. At the high end of the estimate fibroids are one of the most expensive disorders of women. Even at the lower end of five point eight billion dollars per year the cost is considerable. Our results emphasize the need to develop new effective treatments for uterine fibroids because in our sensitivity analysis we found that if one could reduce the number of women undergoing hysterectomy each year, to minimize that number we would save twentyfive percent of the associated health care costs.