The Cost of Untreated Vasomotor Symptoms

Women with untreated vasomotor symptoms (VMS) have more frequent outpatient visits and more direct and indirect costs related to the symptoms than women without VMS, a new study finds.

Key Points:

- Untreated VMS are associated with significantly higher healthcare utilization, work loss, and cost burden.

- The incremental direct cost of VMS for the study population was $339,559,458 across 1 year.

- Indirect costs attributable to work loss related to untreated VMS totaled $27,668,410 across 1 year for the study population.

VMS occur in about 75% of postmenopausal women with naturally occurring menopause and about 90% of women who have undergone hysterectomy, explain the study authors. In most women, however, moderate to severe VMS are untreated. In addition to hot flashes, women can also experience sleep disturbances, anxiety, depression, irritability, and memory impairment-all of which can affect quality of life. In this study, researchers aimed to identify the broader effect of untreated VMS in terms of health care resource utilization, work loss, and cost burden.

Using health insurance claims data from 1999 to 2011, researchers identified more than 250,000 women with untreated VMS and matched them to the same number of women without VMS.

During the 12-month follow-up, women with untreated VMS (mean age, 56 y) used significantly more healthcare resources than women in the control cohort. Specifically, the number of all-cause outpatient visits were 82% higher (95% CI, 81-83; P < 0.001) and the number of VMS-related outpatient visits were 121% higher (95% CI, 118-124; P < 0.001).

There were also cost effects, with costs being broken down to direct costs (those related to healthcare) and indirect costs (those attributable to work loss). The direct costs were $1346 more per patient per year (PPPY) and indirect costs were $770 more PPPY for women with untreated VMS, compared with the control cohort. Indirect costs were calculated based on women with untreated VMS having 57% more indirect work productivity loss days than controls.

Considering that more than 80% of VMS diagnoses are made at visits unrelated to the well-woman exam, the researchers suggest that women tend not to seek treatment for VMS even with the symptoms significantly impact their daily function.

"This high potential burden on women, employers, and the healthcare system illustrates the need to recognize the existence of VMS and their potentially negative effects on working women," wrote the study authors.

The study was published in the March 2015 issue of Menopause.