Treatment patterns for women with new episodes of uterine myomas in an insured population in the US.
BACKGROUND
Uterine myomas are the most common benign tumors in reproductive-aged women and a leading reason for gynecologist visits and hysterectomies in the United States. This study examines the treatment patterns of insured women with new episodes of uterine myomas.


METHODS
We used administrative claims from a proprietary research database to evaluate services (inpatient, outpatient, and prescription claims) incurred from January 1, 2001 to December 31, 2003. We identified women with CPT or ICD-9-CM codes suggestive of myoma and described treatment patterns for all women with a new episode of myoma and those with abnormal bleeding.


RESULTS
The primary study group included 35 329 women with new episodes of care and at least three months of data before and after their index date for myoma. Most women (82.9%) had no code for diagnostic testing in the three months before or after the first myoma marker. Of 14 434 women with one year of follow-up, 26.1% had surgery and 24.7% were treated pharmacologically (oral contraceptives, progestins, or gonadotropin-releasing hormone agonists). Over half (55.1%) of women were untreated, including 45% of those with an ICD-9 code that indicated abnormal bleeding.


CONCLUSIONS
Women with new myoma episodes rarely had codes for confirmatory diagnostic tests. Many women with myomas go untreated for at least a year. This is true even for those with evidence of abnormal bleeding. Myoma care may be improved through the introduction of new, safe, and effective therapies.
Broder
Michael S
MS
Partnership for Health Analytic Research, LLC, Los Angeles, CA 90025-7017, USA. mbroder@pharllc.com
Spalding
James
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D007348:Insurance, Health; D038801:International Classification of Diseases; D008875:Middle Aged; D009214:Myoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*