Hazimeh Dana, Coco Abigail, Casubhoy Imaima, Segars James, Singh Bhuchitra
Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Research, Johns Hopkins Medicine, Baltimore, MD, 21205, USA.
Division of Reproductive Sciences & Women's Health Research, Department of Gynecology & Obstetrics, Johns Hopkins School of Medicine, 720 Rutland Avenue Ross Research Building, Room 624, Baltimore, MD, 21205, USA.
Reprod Sci. 2024 Dec;31(12):3743-3756. doi: 10.1007/s43032-024-01727-0. Epub 2024 Oct 25.
In 2010, the estimated annual cost of uterine fibroids in the United States ranged from 5.9 to 34.4 billion USD. In the past decade, more uterine-sparing and fertility preserving interventions have become available to treat symptomatic fibroids. This comparative cost-analysis aims to evaluate change in societal costs of uterine fibroids in the US between 2010 and 2022 given changing fibroid and obstetric management, population growth, and inflation. A systematic review was conducted to update uterine fibroid, treatment, and obstetric complication prevalence, direct costs of medical and surgical interventions, indirect productivity costs, and obstetric costs attributable to fibroids in 2022. A comparative cost-analysis with paired t-tests was performed using baseline data published in 2010. Percent (%) changes between 2010 and 2022 were reported. NIH research funding for fibroids and other common diseases was compared. All costs were converted to 2023 USD. The number of US women with uterine fibroids increased by 10.6% from 2010 to 2022. Over this period, the economic burden of uterine fibroids increased up to 41.4 billion USD compared to 34.4 billion USD in 2010. Overall costs increased to 42.2 billion USD after incorporating new costs associated with MRgFUS and infertility. Direct costs of medical management decreased while costs of surgical interventions increased as a result of evolving treatment-seeking behavior. Lost work costs continue to account for the largest proportion of the economic burden for fibroids. Cesarean section delivery remains the largest contributor (average 80.0%) to indirect obstetrical costs. Despite the rise in the number of individuals affected by uterine fibroids and its sizable annual cost to society, uterine fibroids research continues to be underfunded.
2010年，美国子宫肌瘤的年度估计成本在59亿至344亿美元之间。在过去十年中，出现了更多保留子宫和保留生育功能的干预措施来治疗有症状的肌瘤。这项比较成本分析旨在评估2010年至2022年期间，鉴于肌瘤和产科管理的变化、人口增长以及通货膨胀，美国子宫肌瘤的社会成本变化。进行了一项系统综述，以更新2022年子宫肌瘤、治疗方法和产科并发症的患病率、医疗和手术干预的直接成本、间接生产力成本以及归因于肌瘤的产科成本。使用2010年公布的基线数据进行了配对t检验的比较成本分析。报告了2010年至2022年期间的百分比（%）变化。比较了美国国立卫生研究院对肌瘤和其他常见疾病的研究资金。所有成本均换算为2023年美元。从2010年到2022年，美国患有子宫肌瘤的女性人数增加了10.6%。在此期间，子宫肌瘤的经济负担增加到414亿美元，而2010年为344亿美元。纳入与磁共振引导聚焦超声治疗（MRgFUS）和不孕症相关的新成本后，总成本增至422亿美元。由于寻求治疗行为的演变，医疗管理的直接成本下降，而手术干预的成本增加。误工成本在肌瘤的经济负担中仍占最大比例。剖宫产仍然是间接产科成本的最大贡献者（平均80.0%）。尽管受子宫肌瘤影响的人数有所增加，且其每年给社会带来相当大的成本，但子宫肌瘤研究的资金仍然不足。
