title: Incremental direct and indirect costs of untreated vasomotor symptoms.
abstract: OBJECTIVE
  Most women with moderate to severe vasomotor symptoms (VMS) are untreated. This retrospective matched-cohort study aims to evaluate the healthcare resource utilization, work loss, and cost burden associated with untreated VMS.
  
  
  METHODS
  Health insurance claims (1999-2011) were used to match (1:1) women with untreated VMS with control women using propensity score. Healthcare resource utilization, work productivity loss (disability + medically related absenteeism), and associated costs were compared between cohorts.
  
  
  RESULTS
  During the 12-month follow-up, women with untreated VMS (n = 252,273; mean age, 56 y) had significantly higher healthcare resource utilization than women in the control cohort: 82% higher for all-cause outpatient visits (95% CI, 81-83; P < 0.001) and 121% higher (95% CI, 118-124; P < 0.001) for VMS-related outpatient visits. Mean direct costs per patient per year were significantly higher for VMS women (direct cost difference, US$1,346; 95% CI, 1,249-1,449; P < 0.001). VMS women had 57% (95% CI, 51-63; P < 0.001) more indirect work productivity loss days than controls, corresponding to an incremental indirect cost per patient per year associated with untreated VMS of US$770 (95% CI, 726-816; P < 0.001).
  
  
  CONCLUSIONS
  This study shows that untreated VMS are associated with significantly higher frequency of outpatient visits and incremental direct and indirect costs.
authors.affiliation: From the 1Departments of Obstetrics and Gynecology and Psychiatry, Yale University School of Medicine, New Haven, CT; 2Columbus Center for Women's Health Research, Columbus, OH; 3Groupe d'analyse, Ltée, Montréal, QC, Canada; 4Analysis Group Inc, Boston, MA; and 5Noven Pharmaceuticals Inc, New York, NY.
authors.forename: Philip
authors.initials: P
authors.lastname: Sarrel
authors.forename: David
authors.initials: D
authors.lastname: Portman
authors.forename: Patrick
authors.initials: P
authors.lastname: Lefebvre
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Lafeuille
authors.forename: Amanda Melina
authors.initials: AM
authors.lastname: Grittner
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fortier
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gravel
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.forename: Peter M
authors.initials: PM
authors.lastname: Aupperle
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D004180:Direct Service Costs; D004526:Efficiency; D005260:Female; D005102:Health Expenditures; D019584:Hot Flashes / Q000191:economics*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057216:Propensity Score; D012189:Retrospective Studies; D055815:Young Adult