title: Economic burden of nausea and vomiting of pregnancy in the USA.
abstract: BACKGROUND
  Nausea and vomiting of pregnancy (NVP) is the most common medical condition during gestation, affecting 50%-90% of women during their first trimester, and many in the second and third trimester. NVP affects women's quality of life and exerts a large economic impact on patients, caregivers and society.
  
  
  OBJECTIVE
  To estimate the overall economic burden of illness of NVP in the USA.
  
  
  METHODS
  A spreadsheet model was utilized to estimate this burden including direct and indirect costs. Costs are reported in 2012 US dollars and were estimated from the perspective of society. Cost centers included drug treatments for mild to severe NVP and hospitalizations for hyperemesis gravidarum (HG), as well as time lost from work and caregiver time. Clinical, epidemiologic, and economic data were obtained from the literature to populate the model. Rates of drug use were multiplied by unit costs and summed.
  
  
  RESULTS
  The estimated total economic burden in 2012 in the USA was $1,778,473,782 which included $1,062,847,276 (60%) in direct costs and $715,626,506 (40%) in indirect costs. Overall, the average cost to manage one woman for NVP was $1827. Costs increased with increasing severity of NVP. The estimates were conservative, as not all applicable costs could be included.
  
  
  CONCLUSIONS
  NVP results in a significant economic impact, and hence effective therapy should be sought. Future prospective research should determine in more detail what resources are utilized in the USA to manage women with NVP.
authors.affiliation: PIVINA Consulting Inc., Mississauga, ON, Canada. charles.piwko@utoronto.ca
authors.forename: Charles
authors.initials: C
authors.lastname: Piwko
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.forename: Vusal
authors.initials: V
authors.lastname: Babashov
authors.forename: Colin
authors.initials: C
authors.lastname: Vicente
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Einarson
mesh_terms: D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D018803:Models, Economic; D048968:Morning Sickness / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States / Q000453:epidemiology