The Economic Burden of Endometriosis

Endometriosis incurs a significant economic burden on patients and society. Here is how the disease affects the economy.

Studies on the economic burden of endometriosis

There are significant direct and indirect costs associated with endometriosis. Direct costs are borne by patients in the form of healthcare and pharmacy expenditures. Indirect costs have to be borne by employers and organizations due to absenteeism, short-term disability, and long-term disability of affected employees.

A 2018 study, which included 113,506 endometriosis patients, found that these individuals had significantly higher health resource utilization rates during diagnosis and treatment compared to controls. The study notes that the mean adjusted total treatment cost per patient during the first 12 months after diagnosis was about $16,573. This was three times higher than for controls without endometriosis.

The incremental 12-month direct and indirect costs came to about $10,000 and $2,132, respectively per endometriosis patient. Long-term disability rates were generally low. However, considering a $240 per day daily wage, the loss incurred in work due to absence and short-term disability was higher than in the case of those with long-term disability. Absenteeism (calling out work) cost companies $5,383 per patient compared to $4,224 for people with no endometriosis. Similarly, short-term disability meant that companies incurred a cost of $1,709 per patient compared to $402 for controls.

A 2019 Australian national survey found that women with chronic pelvic pain had a high cost of illness burden of between $16,970 and $20,898 per woman per year. The majority of the costs were due to productivity loss.

Another 2019 study involving 1,450 women with laparoscopically-confirmed endometriosis pitted the average cost to society per woman at $16,116. Indirect costs due to productivity loss were three times higher at $13,048 compared to $3,066 in direct costs incurred due to medical care.

The annual burden of endometriosis-associated symptoms ranged from $2 billion in Denmark to $119 billion in the US.

The cost of infertility treatments

Endometriosis can adversely impact the outcomes of infertility treatments such as in vitro fertilization (IVF). Research has shown that eggs harvested from endometriosis patients are more likely to fail in IVF.

Donor eggs can significantly increase the chances of getting pregnant, but these need to come from a donor egg bank. Many patients fight infertility for years, and the cost of the whole process can add up quickly.

For instance, an 18-month prospective cohort study found that the median per person costs start from $1,182 for IVF medications alone. This can increase to $24,373 when the procedure is included and up to $38,015 for IVF with donor eggs.

Insurance coverage for fertility treatments is not uniform across the US. Insurance companies do not usually consider fertility as “medically necessary”. Even if States do have infertility insurance coverage laws that govern private insurance, the eligibility of patients can vary. In some States, symptoms like unexplained infertility, which is characteristic of silent endometriosis, can qualify for IVF coverage only after five years of infertility while others have a restriction of one year.

Other factors that can affect insurance coverage include the nature of the funding, marital status, age, and sexual orientation. Insurance companies usually do not cover surrogacy costs.

The role of advocacy and research

Endometriosis can incur a significant economic burden in many spheres of life. A major impediment is a misconception about the disease and its treatment. It is therefore of great importance to invest resources in research. Only then can cost-effective treatment avenues be developed. This can in turn improve patients’ overall quality of life and reduce the disease burden on society.

Initiatives such as the UpEndo Coalition created by the Endometriosis Foundation of America (EndoFound) press upon the need for Congressional funding and public education. This not only improves awareness and sensitization on a family or personal level but also reduces the individual burden of the disease thanks to public funding.

Citizens can advocate for themselves, voice their stories, and make sure their representatives recognize the sizeable disease burden. The importance of techniques such as laparoscopic deep excision surgery in reducing the impact of endometriosis in a relatively shorter period can also be outlined.

Laparoscopic deep excision surgery can be a cost-effective treatment option for endometriosis

Gynecologists typically recommend procedures such as hysterectomy and oophorectomy as a “cure” for endometriosis. However, these techniques result in permanent surgical infertility. These procedures can turn out to be significantly expensive with no guarantee of symptom alleviation.

Laparoscopic deep excision surgery is the gold standard for endometriosis diagnosis and treatment. The surgeons at Seckin Endometriosis Center have years of experience with this technique, combining it with other innovations such as Aqua Blue Contrast^™. This procedure is highly cost-effective, requires a minimal hospital stay, offers fast recovery rates, has low symptom recurrence rates, and greatly improves the chances of getting pregnant.

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