Azziz Ricardo, Marin Catherine, Hoq Lalima, Badamgarav Enkhe, Song Paul
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 160 W, Los Angeles, California 90048, USA.
J Clin Endocrinol Metab. 2005 Aug;90(8):4650-8. doi: 10.1210/jc.2005-0628. Epub 2005 Jun 8.
The polycystic ovary syndrome (PCOS) is the most common endocrine abnormality of reproductive-aged women today, affecting approximately 6.6% of unselected reproductive-aged women (approximately 4 million women in the United States) (1990 National Institutes of Health criteria), and potentially represents a significant financial burden to our health care.
The objective of the study was to define, using current definitions and prevalence or incidence data, the minimal economic burden that PCOS in reproductive-aged women represents for the United States.
The study design was a literature review.
The study was conducted at a tertiary care center.
There were no patients or other participants.
INTERVENTION(S): We performed a systematic review of the published medical literature to identify studies evaluating epidemiology of reproductive-age PCOS and its clinical consequences and costs. We tied general societal cost data for the different health consequences to reproductive-age PCOS costs, using prevalence data.
MAIN OUTCOME MEASURE(S): The main measure in the study was total health care-related economic costs.
We estimated the mean annual cost of the initial evaluation to be dollar 93 million (2.1% of total costs), that of hormonally treating menstrual dysfunction/abnormal uterine bleeding to be dollar 1.35 billion (31.0% of total), that of providing infertility care to be dollar 533 million (12.2% of total), that of PCOS-associated diabetes to be dollar 1.77 billion (40.5% of total), and that of treating hirsutism to be dollar 622 million (14.2% of total).
The total cost of evaluating and providing care to reproductive-aged PCOS women in the United States is dollar 4.36 billion. Because the cost of the diagnostic evaluation accounted for a relatively minor part of the total costs (approximately 2%), more widespread and liberal screening for the disorder appears be a cost-effective strategy, leading to earlier diagnosis and intervention and possibly the amelioration and prevention of serious sequelae.
多囊卵巢综合征（PCOS）是当今育龄女性中最常见的内分泌异常疾病，影响约6.6%未经筛选的育龄女性（在美国约有400万女性）（根据1990年美国国立卫生研究院标准），并且可能给我们的医疗保健带来巨大经济负担。
本研究的目的是使用当前的定义以及患病率或发病率数据，确定育龄女性PCOS给美国带来的最低经济负担。
本研究设计为文献综述。
本研究在一家三级医疗中心进行。
无患者或其他参与者。
我们对已发表的医学文献进行了系统综述，以识别评估育龄期PCOS的流行病学及其临床后果和成本的研究。我们利用患病率数据，将不同健康后果的一般社会成本数据与育龄期PCOS的成本联系起来。
本研究的主要指标是与医疗保健相关的总经济成本。
我们估计初始评估的年均成本为9300万美元（占总成本的2.1%），激素治疗月经功能障碍/异常子宫出血的年均成本为13.5亿美元（占总成本的31.0%），提供不孕治疗的年均成本为5.33亿美元（占总成本的12.2%），PCOS相关糖尿病的年均成本为17.7亿美元（占总成本的40.5%），治疗多毛症的年均成本为6.22亿美元（占总成本的14.2%）。
在美国，评估和治疗育龄期PCOS女性的总成本为43.6亿美元。由于诊断评估成本在总成本中占比较小（约2%），因此更广泛和宽松的该疾病筛查似乎是一种具有成本效益的策略，可导致早期诊断和干预，并可能改善和预防严重后遗症。
