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. 2019 Oct 10;14(10):e0223316.
doi: 10.1371/journal.pone.0223316. eCollection 2019.

The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey

Mike Armour  1   2 , Kenny Lawson  2 , Aidan Wood  1   2 , Caroline A Smith  1   2 , Jason Abbott  3
Affiliations

The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey

Mike Armour et al. PLoS One. .

Abstract

Introduction: Endometriosis has a significant cost of illness burden in Europe, UK and the USA, with the majority of costs coming from reductions in productivity. However, information is scarce on if there is a differing impact between endometriosis and other causes of chronic pelvic pain, and if there are modifiable factors, such as pain severity, that may be significant contributors to the overall burden.

Methods: An online survey was hosted by SurveyMonkey and the link was active between February to April 2017. Women aged 18-45, currently living in Australia, who had either a confirmed diagnosis of endometriosis via laparoscopy or chronic pelvic pain without a diagnosis of endometriosis were included. The retrospective component of the WERF EndoCost tool was used to determine direct healthcare costs, direct non-healthcare costs (carers) and indirect costs due to productivity loss. Estimates were extrapolated to the Australian population using published prevalence estimates.

Results: 407 valid responses were received. The cost of illness burden was significant in women with chronic pelvic pain (Int $16,970 to $ 20,898 per woman per year) irrespective of whether they had a diagnosis of endometriosis. The majority of costs (75-84%) were due to productivity loss. Both absolute and relative productivity costs in Australia were higher than previous estimates based on data from Europe, UK and USA. Pain scores showed the strongest relationship to productivity costs, a 12.5-fold increase in costs between minimal to severe pain. The total economic burden per year in Australia in the reproductive aged population (at 10% prevalence) was 6.50 billion Int $.

Conclusion: Similar to studies in European, British and American populations, productivity costs are the greatest contributor to overall costs. Given pain is the most significant contributor, priority should be given to improving pain control in women with pelvic pain.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: MA,CS, AT: As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies and industry. Sponsors and donors provide untied and tied funding for work to advance the vision and mission of the Institute. This study was not specifically supported by donor or sponsor funding to NICM. JA: reports he is a committee member for the Endometriosis National Action plan implementation committee in Australia and the president of the Australasian Gynaecological Endoscopy and Surgery (AGES) Society. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Cost breakdown for women with a diagnosis of endometriosis.
Fig 2
Fig 2. Cost breakdown for women with CPP.
Fig 3
Fig 3. Costs broken down by pain severity (Int $).
See this image and copyright information in PMC

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