Presentation (CTI)

OBJECTIVES: Fiscal modelling captures the impact of disease beyond healthcare costs by quantifying effects on government revenues and expenditures and estimating the return on investment of health interventions. Although the economic burden of menopause has been documented, its fiscal impact has not. We estimated the annual fiscal impact of menopausal symptoms in England and Wales and identified key evidence gaps affecting these estimates.
METHODS: A fiscal model was developed to estimate the impact of menopausal symptoms on government finances in England and Wales. The model incorporated published evidence on menopause-related absenteeism, unemployment, and early retirement. Consequent changes in government revenues (personal income tax and employee and employer National Insurance contributions) and expenditures (healthcare costs, including hormone replacement therapy, antidepressants, counselling, primary and specialist care; occupational sick pay for public sector employees) were estimated. Tax and benefit calculations were based on age-specific female income distributions. Scenario analyses additionally considered reduced value added tax revenues associated with lower earnings and consumption, and productivity losses from presenteeism among public sector employees. AI-assisted searches identified relevant publications and data sources; all model inputs were extracted from the original sources.
RESULTS: An estimated 2.2 million women experience menopausal symptoms annually in England and Wales. The resulting annual net fiscal impact was estimated at £1.01 billion, of which 50% was attributable to healthcare costs, 42% to foregone tax and contributions, and 8% to government transfers. Evidence linking menopausal symptoms to benefit claims, including Universal Credit and New Style Employment and Support Allowance, would enable inclusion of additional quantitatively important fiscal effects.
CONCLUSIONS: Menopause imposes a substantial fiscal burden on the UK government. Incorporating fiscal consequences into the evaluation of menopause interventions could support more informed and equitable resource allocation by providing a more comprehensive assessment of value. Improved evidence on menopause-related benefit receipt would further strengthen fiscal evaluations.