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. 2023 Oct 16:15:1561-1575.
doi: 10.2147/IJWH.S420612. eCollection 2023.

Describing the Patient Journey of Women with Claims for Uterine Fibroids and Heavy Menstrual Bleeding Using a Commercial Database (2011-2020)

Sanjay K Agarwal  1 , Michael Stokes  2 , Tiffany Kung  3 , Rong Tilney  2 , Cassandra Lickert  3
Affiliations

Describing the Patient Journey of Women with Claims for Uterine Fibroids and Heavy Menstrual Bleeding Using a Commercial Database (2011-2020)

Sanjay K Agarwal et al. Int J Womens Health. .

Abstract

Introduction: This retrospective database claims analysis describes the clinical characteristics and treatment patterns of commercially insured United States women with uterine fibroids (UF) and heavy menstrual bleeding (HMB).

Methods: Women age 18-55 years with an incident UF diagnosis (index date) between 1/1/2012 and 12/31/2019 and ≥1 claim for HMB (UF-HMB), were identified from the Optum® Clinformatics® database. Outcomes included clinical characteristics, pharmacologic therapy use, and surgeries/procedures. Regression models were used to identify factors associated with time to post-diagnosis hormonal therapy and hysterectomy.

Results: A total of 85,428 women had UF-HMB (mean [SD] age, 43.7 [6.4] years). The median follow-up was 3.2 years. After HMB, the most common symptoms were pelvic pressure/pain (27.6%) and backache (17.5%). Within 6 months of UF diagnosis, 40.2% of patients had received only pharmacologic therapy; 25.5% had received no treatment; 24.3% had a hysterectomy, and 10.0% had other procedures. By the end of follow-up, 50.0% had received a hysterectomy. Multiple factors were predictive of a higher likelihood of receiving hormonal therapy (geographic region, infertility, pre-index pregnancy) or hysterectomy (older age, prior hormonal treatment, specific bulk symptoms, White race).

Conclusion: Within 6 months of UF diagnosis, fewer than one-half of women with UF-HMB had received hormonal therapy, one-quarter received no treatment, and one-quarter had received a hysterectomy or another gynecologic procedure. Patients who received a hysterectomy were more likely to be older, White, and to have bulk symptoms.

Keywords: heavy menstrual bleeding; leiomyoma; menorrhagia; uterine fibroids.

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Conflict of interest statement

SKA is a consultant to Myovant (now known as Sumitomo Pharma America, Inc)/Pfizer and AbbVie as well as a member of the AbbVie speakers’ bureau. MS is an employee of Evidera, which received consulting fees from Myovant (now known as Sumitomo Pharma America, Inc) for this study. TK was an employee of Myovant Sciences Inc (now known as Sumitomo Pharma America, Inc). RT was an employee of Evidera. CL is an employee of Myovant Sciences Inc (now known as Sumitomo Pharma America, Inc). The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Patient Treatment Patterns Through 24 Months.
Figure 2
Figure 2
UF-related Pharmacotherapy Use Before and After Initial UF Diagnosis.
Figure 3
Figure 3
KM Analysis of Time to Hysterectomy.
Figure 4
Figure 4
Forest Plot of Multivariate Cox Proportional Hazards Model, Time to (A) Initiation of Hormonal Therapy and (B) Hysterectomy. *Measured during 6-month intervals post-UF diagnosis.
See this image and copyright information in PMC

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