OBJECTIVES : The aim was to describe polycystic ovary syndrome (PCOS) patients in terms of clinical characteristics, medication utilization, and healthcare costs stratified by body mass index (BMI) categories.

METHODS

: This retrospective, observational study utilized claims linked to electronic health record data contained in the IBM MarketScan Explorys Claims-EHR Data Set. Patients with at least one diagnosis for PCOS (ICD-9-CM 256.4; ICD-10: E282; SNOMED: 69878008) from 1/1/2007 through 6/30/2017 were selected. Patients were required to be continuously enrolled in the database, and with no evidence of pregnancy, during the 12-month observation period (6 months before and after the PCOS diagnosis). Clinical characteristics, medication utilization, lab results and all-cause healthcare costs were described. Patients were stratified into four BMI subgroups: normal or underweight, overweight, obese, and morbidly obese.

RESULTS : A total of 4,142 PCOS patients met the selection criteria, of whom, 16% were normal or underweight, 17% were overweight, 40% were obese and 27% were morbidly obese. The mean age was 32 years. Approximately 22% of morbidly obese patients were diagnosed with type 2 diabetes, compared to 13%, 7% and 3% in the obese, overweight and normal/underweight subgroups, respectively. Acne was more often diagnosed in the lower weight patient subgroups (normal/underweight 22%; overweight 15%; obese 11%; morbidly obese 6%). Cardiovascular conditions were rare. Oral contraceptives were more commonly utilized in the lower BMI categories, while opioids and nonsteroidal anti-inflammatory drugs were more common in higher BMI categories. HbA1c levels did not differ between BMI categories. Mean and median total healthcare costs were highest in the morbidly obese patients.

CONCLUSIONS : This descriptive analysis provides real-world evidence of the variation in the clinical and economic burden of PCOS based on the presence of comorbid obesity. Further research is needed into the impact of obesity on comorbidity disease management, treatment and healthcare costs among women with PCOS.