title: What are the total costs of surgical treatment for uterine fibroids?
abstract: OBJECTIVE
  To investigate the direct and indirect costs of uterine fibroid (UF) surgery.
  
  
  METHODS
  Data were obtained from the MarketScan Commercial Claims and Encounters databases for 1999-2004. Our sample included 22,860 women with insurance coverage who were treated surgically for UF and 14,214 women who were treated nonsurgically for UF. Medical care costs and missed workdays were divided into baseline (1 year prior to surgery) and postoperative (1 year after surgery) periods. For a subsample of women, we calculated average annual costs 3 years before and after their surgery.
  
  
  RESULTS
  Of patients electing surgery, 85.9% underwent hysterectomy, 7.6% myomectomy, 4.9% endometrial ablation, and 1.6% uterine artery embolization (UAE). Women undergoing UAE incurred the highest medical care costs in the operative year ($16,430 unadjusted, $20,634 adjusted for confounders), followed by hysterectomy ($15,180 unadjusted, $17,390 adjusted), myomectomy ($14,726 unadjusted, $18,674 adjusted), and endometrial ablation ($12,096 unadjusted, $13,019 adjusted). Women treated nonsurgically incurred costs of $7,460 unadjusted and $8,257 adjusted during the year after they were diagnosed with UF. Three years after surgery, patients treated with hysterectomy had the lowest annual costs. Missed workdays in the year after surgery were high, resulting in significant losses to employers in the magnitude of $6,670-$25,229, depending on treatment, values assigned to missed workdays, and whether the analyses adjusted for confounders.
  
  
  CONCLUSIONS
  UF surgical treatment costs were high. Absenteeism and disability were important components of the cost burden of UF treatment for women, their employers, and the healthcare system.
authors.affiliation: Thomson Healthcare, Research Division, Ann Arbor, Michigan, USA. Ginger.Carls@thomsonreuters.com
authors.forename: Ginger Smith
authors.initials: GS
authors.lastname: Carls
authors.forename: David W
authors.initials: DW
authors.lastname: Lee
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ozminkowski
authors.forename: Shaohung
authors.initials: S
authors.lastname: Wang
authors.forename: Teresa B
authors.initials: TB
authors.lastname: Gibson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stewart
mesh_terms: D000041:Absenteeism; D000328:Adult; D016208:Databases, Factual; D055356:Endometrial Ablation Techniques / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000191:economics; D007889:Leiomyoma / Q000191:economics* / Q000601:surgery; D008875:Middle Aged; D009786:Occupational Health Services; D012044:Regression Analysis; D014481:United States; D055357:Uterine Artery Embolization / Q000191:economics; D014594:Uterine Neoplasms / Q000191:economics* / Q000601:surgery