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Health Care-Related Economic Burden of the Polycystic Ovary Syndrome during the Reproductive Life Span

Department of Obstetrics and Gynecology (R.A., C.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Departments of Obstetrics and Gynecology (R.A., C.M.) and Medicine (R.A.), The David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California 90095; and Cerner Health Insights (L.H., E.B., P.S.), Beverly Hills, California 90212

Address all correspondence and requests for reprints to: Ricardo Azziz, M.D., M.P.H., M.B.A., Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 160 W, Los Angeles, California 90048. E-mail: azzizr{at}cshs.org.

Context: 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 (4 million women in the United States) (1990 National Institutes of Health criteria), and potentially represents a significant financial burden to our health care.

Objective: 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.

Design: The study design was a literature review.

Setting: The study was conducted at a tertiary care center.

Patients or Other Participants: 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.

Results: We estimated the mean annual cost of the initial evaluation to be $93 million (2.1% of total costs), that of hormonally treating menstrual dysfunction/abnormal uterine bleeding to be $1.35 billion (31.0% of total), that of providing infertility care to be $533 million (12.2% of total), that of PCOS-associated diabetes to be $1.77 billion (40.5% of total), and that of treating hirsutism to be $622 million (14.2% of total).

Conclusions: The total cost of evaluating and providing care to reproductive-aged PCOS women in the United States is $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.

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