title: Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population.
abstract: BACKGROUND
  Postmenopausal women have a significant risk of developing a number of chronic conditions including osteoporosis (OP), breast cancer (BrCa), and cardiovascular disease (CVD). These diseases can result in significant direct (medical treatment) and indirect (workplace) costs. The objective of this study is to assess these costs among an employed population.
  
  
  METHODS
  Deidentified medical and disability claims data from seven large employers (n = 585,441) were analyzed from 1998 through 2000 for female employees, age 50-64 years. Medical claim ICD-9CM codes were used to identify patients treated for: OP (n = 2,314), BrCa (n = 555), and CVD (n = 1,710). Each disease cohort was compared to a random sample of 50- to 64-year-old female employees (n = 7,575). Descriptive and multivariate techniques were used to characterize direct and indirect costs attributable to each condition.
  
  
  RESULTS
  Average annual direct costs were higher (p < .001) for female employees treated for OP (6,259 dollars), BrCa (13,925 dollars), or CVD (12,055 dollars) when compared with the random sample (2,951 dollars). In addition, average annual indirect costs associated with OP (4,039 dollars), BrCa (8,236 dollars), and CVD (4,990 dollars) were higher (p < .001) than indirect costs for the random sample (2,292 dollars). Even when controlling for each disease-state cohort's demographics and disease-specific comorbidities, patients treated for OP, BrCa, and CVD continued to have significantly greater direct and indirect costs (p < .001) than the random sample.
  
  
  CONCLUSIONS
  Chronic conditions such as OP, BrCa, and CVD, which occur more frequently in women after menopause, impose a significant financial burden. Greater health care utilization and work-loss prevalence among women treated for these conditions contribute to these additional costs.
authors.affiliation: Analysis Group, Inc., Boston, Massachusetts, USA. asasser@analysisgroup.com
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Sasser
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Rousculp
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Emily F
authors.initials: EF
authors.lastname: Oster
authors.forename: Edward
authors.initials: E
authors.lastname: Lufkin
authors.forename: David
authors.initials: D
authors.lastname: Mallet
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000191:economics* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology; D002908:Chronic Disease; D017281:Cost of Illness; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D017049:Employer Health Costs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000191:economics* / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States; D014931:Women, Working / Q000706:statistics & numerical data*