The Cost and Utility of Endometriosis in Portugal: Results From a National Online Survey
Author(s)
Joao Pereira, BA, MSc, DPhil1, Maria Diniz-Costa, BSc, MSc, PhD2.
1Full Professor, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal, 2Researcher, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal.
1Full Professor, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal, 2Researcher, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal.
OBJECTIVES: Endometriosis affects approximately 10% women of reproductive age. There is often a delay between onset of symptoms, diagnosis and initiation of effective treatment which leads to a considerable economic burden and poor health related quality of life that is yet poorly understood. Available health economic analyses, in a few countries, show that reductions in productivity are a significant driver of costs. The present study aimed to estimate the direct and indirect economic burden and utility scores for patients with diagnosed endometriosis in Portugal.
METHODS: An online survey was hosted by REDCap with the link active during February/March 2025. Women aged 18-50, living in Portugal, who had a confirmed medical diagnosis of endometriosis were included. The retrospective module of the World Endometriosis Research Foundation EndoCost tool was used. Cost estimation followed a bottom-up prevalence cost-of-illness approach. Direct (medical and non-medical) costs and indirect costs due to productivity loss were determined. Estimates were extrapolated to the Portuguese population using prevalence estimates. For the utility component the EQ-5D-5L questionnaire was applied.
RESULTS: 425 valid responses were received. The cost of illness burden in women with endometriosis was significant (8 217 € per woman per year). Most costs (74%) were due to productivity loss. Recent medical interventions and EQ-5D-5L scores showed the strongest relationship to productivity costs. The total economic burden per year in Portugal was 1.27€ billion. Compared to the general population, EQ-5D-5L scores were persistently poorer for surveyed women, with differences greater for the pain/discomfort dimension. Younger participants with comorbidities and difficulties in carrying out activities of daily living showed poorer EQ-5D-5L scores.
CONCLUSIONS: Similar to studies in other populations, societal costs of endometriosis in Portugal are considerable, with productivity costs the greatest contributor to overall costs. Given HRQoL loss shown, priority should be given to improving pain control in women with endometriosis.
METHODS: An online survey was hosted by REDCap with the link active during February/March 2025. Women aged 18-50, living in Portugal, who had a confirmed medical diagnosis of endometriosis were included. The retrospective module of the World Endometriosis Research Foundation EndoCost tool was used. Cost estimation followed a bottom-up prevalence cost-of-illness approach. Direct (medical and non-medical) costs and indirect costs due to productivity loss were determined. Estimates were extrapolated to the Portuguese population using prevalence estimates. For the utility component the EQ-5D-5L questionnaire was applied.
RESULTS: 425 valid responses were received. The cost of illness burden in women with endometriosis was significant (8 217 € per woman per year). Most costs (74%) were due to productivity loss. Recent medical interventions and EQ-5D-5L scores showed the strongest relationship to productivity costs. The total economic burden per year in Portugal was 1.27€ billion. Compared to the general population, EQ-5D-5L scores were persistently poorer for surveyed women, with differences greater for the pain/discomfort dimension. Younger participants with comorbidities and difficulties in carrying out activities of daily living showed poorer EQ-5D-5L scores.
CONCLUSIONS: Similar to studies in other populations, societal costs of endometriosis in Portugal are considerable, with productivity costs the greatest contributor to overall costs. Given HRQoL loss shown, priority should be given to improving pain control in women with endometriosis.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD250
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Reproductive & Sexual Health