The Impact of Menopausal Hormone Therapy on Productivity and Health Care Utilization in Women: A Finnish Claims Database Study
Author(s)
Tomi S. Mikkola, MD1, Herman S. Depypere, MD2, Constantino Di Carlo, MD3, Silvia P Gonzalez, MD4, Bettina Mannerström, PhD5, Anne Marciniak, MD6, Johan Rehnberg, PhD7, Petra Stute, MD8, Vikram Talaulikar, MD9, Florence Tremollieres, MD10, Johanna Vikkula, MSC Tech5, Renata Zablotna-Pociupany, MD6, Stavros Iliadis, MD11.
1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, 2Menopause and Breast Clinic of University Hospital, Ghent University Hospital, Ghent, Belgium, 3Department of Public Health, University of Naples Federico II, Naples, Italy, 4University of Alcala Madrid, Madrid, Spain, 5Medaffcon Oy, Espoo, Finland, 6Theramex, London, United Kingdom, 7Medaffcon Ab, Stockholm, Sweden, 8University Hospital Inselspital, Bern, Switzerland, 9Reproductive Medicine and Women’s Health, University College London (UCL), London, United Kingdom, 10Menopause Center, Hôpital Paule de Viguier, University Hospital of Toulouse, Toulouse, France, 11Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, 2Menopause and Breast Clinic of University Hospital, Ghent University Hospital, Ghent, Belgium, 3Department of Public Health, University of Naples Federico II, Naples, Italy, 4University of Alcala Madrid, Madrid, Spain, 5Medaffcon Oy, Espoo, Finland, 6Theramex, London, United Kingdom, 7Medaffcon Ab, Stockholm, Sweden, 8University Hospital Inselspital, Bern, Switzerland, 9Reproductive Medicine and Women’s Health, University College London (UCL), London, United Kingdom, 10Menopause Center, Hôpital Paule de Viguier, University Hospital of Toulouse, Toulouse, France, 11Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
OBJECTIVES: Menopausal symptoms can severely affect quality of life, however, their broader impact on the healthcare system and the lost productivity is not well established. This study aims to compare all-cause healthcare resource utilization (HCRU), and lost productivity for women receiving menopausal hormone therapy (MHT) versus untreated controls, based on nationwide health data registers in Finland.
METHODS: The study includes all women starting systemic MHT between 1.1.2005 and 31.12.2023 identified from the Finnish Reimbursed Medicines Registry with ≥2 MHT purchases within a year (equalling ≥6 months MHT use) and aged 40-70 years at first purchase (index). Controls were selected from the same registry, with no recorded MHT purchase. HCRU was estimated based on healthcare contacts and reimbursed medication purchases. Lost productivity was defined as missed workdays due to disability, and part-time pensions, and long sick leaves (≥10 days) for women <65 years of age (~retirement age). The data for control population is yet to be analysed.
RESULTS: During the follow-up period, 206,485 MHT users were identified, with median follow-up of 9.1 years. Median age at index was 51.6 years. During the first year, estrogen-progestogen was initiated by 60,7%, estrogen by 37,5% and tibolone by 1.8%. At the median follow-up of 9 years, MHT users had an average of 23 specialized care contacts, 90 primary care contacts, and 80 reimbursed medication purchases per person. During the same period, an average of 77 workdays were missed due to long sick leaves, 208 days due to disability pensions, and 7 days due to part-time pensions per person.
CONCLUSIONS: The study cohort includes nearly all women aged 40-70 years in Finland, enabling nationwide analysis of the effect of MHT on healthcare use and productivity. Clinicians and payors should consider the impact of menopausal symptoms on a woman's personal and professional life when evaluating the use of MHT.
METHODS: The study includes all women starting systemic MHT between 1.1.2005 and 31.12.2023 identified from the Finnish Reimbursed Medicines Registry with ≥2 MHT purchases within a year (equalling ≥6 months MHT use) and aged 40-70 years at first purchase (index). Controls were selected from the same registry, with no recorded MHT purchase. HCRU was estimated based on healthcare contacts and reimbursed medication purchases. Lost productivity was defined as missed workdays due to disability, and part-time pensions, and long sick leaves (≥10 days) for women <65 years of age (~retirement age). The data for control population is yet to be analysed.
RESULTS: During the follow-up period, 206,485 MHT users were identified, with median follow-up of 9.1 years. Median age at index was 51.6 years. During the first year, estrogen-progestogen was initiated by 60,7%, estrogen by 37,5% and tibolone by 1.8%. At the median follow-up of 9 years, MHT users had an average of 23 specialized care contacts, 90 primary care contacts, and 80 reimbursed medication purchases per person. During the same period, an average of 77 workdays were missed due to long sick leaves, 208 days due to disability pensions, and 7 days due to part-time pensions per person.
CONCLUSIONS: The study cohort includes nearly all women aged 40-70 years in Finland, enabling nationwide analysis of the effect of MHT on healthcare use and productivity. Clinicians and payors should consider the impact of menopausal symptoms on a woman's personal and professional life when evaluating the use of MHT.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH26
Topic
Economic Evaluation, Epidemiology & Public Health, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Reproductive & Sexual Health