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. 2017 Aug 29:9:525-535.
doi: 10.2147/CEOR.S139335. eCollection 2017.

Burden of uterine fibroids in Italy: epidemiology, treatment outcomes, and consumption of health care resources in more than 5,000 women

Marco Chiumente  1 , Mauro De Rosa  2 , Andrea Messori  2 , Enrica Maria Proli  3
Affiliations

Burden of uterine fibroids in Italy: epidemiology, treatment outcomes, and consumption of health care resources in more than 5,000 women

Marco Chiumente et al. Clinicoecon Outcomes Res. .

Erratum in

Abstract

Background and purpose: Epidemiological studies on uterine fibroids (UFs) are mostly based on surveys or analyses of small samples of patients. In 50% of women, the quality of life is worsened by disease-related symptoms; furthermore, treatments imply a remarkable health care cost. The aim of this observational study was to analyze a large sample of Italian patients with UFs and to assess the epidemiology, the appropriateness of treatments, and the consumption of disease-related resources.

Methods: Data were collected through a data-linkage technique from five administrative databases. Women aged between 18 and 55 years and resident in three local health authorities (north-central-south Italy) were selected over the period from 1st January 2009 to 31st December 2015. The inclusion criteria were a surgical procedure with diagnosis of UFs or a pharmacological treatment with gonadotropin-releasing hormone (GnRH) analogs or ulipristal acetate. Besides the overall descriptive analysis, two comparisons were evaluated: surgery versus no surgery and treatment with GnRH analogs versus ulipristal acetate.

Results: A total of 5,665 women with UFs were selected from an overall population of 2,400,000 people. In the north, 73.6% of patients underwent surgery, as opposed to only 16.7% in the south; 70% of surgeries were hysterectomies. The average cost per patient was €3,249 (duration of follow-up = up to 7 years). The southern district had the highest number of drug prescriptions; in particular, 49% of patients took >10 packages of GnRH analogs.

Conclusion: This study is the first on this topic conducted in Italy using a large sample size. The analysis of resource consumption revealed a high heterogeneity in the choice of drug treatments by gynecologists (especially in the south); in the north, marked variations were seen in the rates of surgery. The long-term use of GnRH was inappropriate.

Keywords: costs and cost analysis; gonadotropin-releasing hormone; leiomyoma; observational study; ulipristal acetate.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Number of patients, included in the main study, divided according to the following criteria: health districts in nonsurgical patients (A), age groups in nonsurgical patients (B), type of surgery in surgical patients (C), and age groups in surgical patients (D). Abbreviation: GnRH, gonadotropin-releasing hormone.
Figure 2
Figure 2
Number of prescribed and reimbursed medication packages per patient. Ulipristal (A) and GnRH analogs (B). Abbreviation: GnRH, gonadotropin-releasing hormone.
Figure 3
Figure 3
Distribution of total direct costs per patients in the main study: overall (A) and divided by surgical and nonsurgical patient groups (B).
Figure 4
Figure 4
Distribution of total direct costs per patients in the ancillary study: overall (A) and divided by GnRH and ulipristal acetate patient groups (B). Abbreviation: GnRH, gonadotropin-releasing hormone.
See this image and copyright information in PMC

References

    1. Rice KE, Secrist JR, Woodrow EL, Hallock LM, Neal JL. Etiology, diagnosis, and management of uterine leiomyomas. J Midwifery Womens Health. 2012;57(3):241–247. - PubMed
    1. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725–736. - PubMed
    1. Wise LA, Laughlin-Tommaso SK. Epidemiology of uterine fibroids: from menarche to menopause. Clin Obstet Gynecol. 2016;59(1):2–24. - PMC - PubMed
    1. Lippman SA, Warner M, Samuels S, Olive D, Vercellini P, Eskenazi B. Uterine fibroids and gynecologic pain symptoms in a population-based study. Fertil Steril. 2003;80(6):1488–1494. - PubMed
    1. Downes E, Sikirica V, Gilabert-Estelles J, et al. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):96–102. - PubMed

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