OBJECTIVES : The prevalence of endometriosis has been increasing throughout the world. Because of the diversified outcomes of endometriosis, the treatment could be a significant burden for the patients and for health care systems as well. The aim of the research was to measure the drug expenditure of the health insurance authority and the out of pocket payment of patients related to the endometriosis between 2015-2019 in Hungary.

METHODS : A retrospective and quantitative study was conducted in Hungary between 2015-2019. Patients suffered from endometriosis were identified with the following code of the International Classification of Diseases 10^th revision: N8090. The expenditure related of endometriosis drugs were analysed from two viewpoints: the reimbursement of health insurance authority, and the out of pocket payments of patients. The Pulvita database was provided by the National Health Insurance Fund of Hungary.

RESULTS : The total drug-reimbursed health insurance expenditure was 8.5 billion Hungarian Forints (HUF) [27.4 million EUR]. 74% of the total health insurance expenditure was related to the dienogest active substance (6.2 billion HUF; 20.1 million EUR). Considering the out of pocket payment of patients, 522.1 million HUF (1.6 million EUR) between 2015-2019 payments were identifiable. 83% of out of pocket payment was also related to the dienogest active substance (434.0 million HUF, 1.4 million EUR). The dienogest consumption has shown a diversified territorial distribution. The highest was in Csongrád county (793.5 mg/10,000 inhabitants) in 2015, while the national mean was 185.9 mg/10,000 inhabitants. In 2019 the highest consumption has been shown in Hajdú-Bihar county (888.9 mg/10,000 inhabitants), while the national mean was 207.1 mg/10,000 inhabitants.

CONCLUSIONS : The reimbursement of health insurance authority related to the endometriosis drugs was remarkable during the study period. The highest drug-consumption of endometriosis was related to the dienogest active substance, which is the most significant drug in endometriosis treatment.