OBJECTIVES : Summarize research studies published between 2000 and 2019 that have evaluated direct, indirect, and surgical costs associated with endometriosis before and after initial diagnosis.

METHODS

: A systematic literature review was conducted in PubMed and EMBASE databases to identify published real-world studies on the direct and indirect costs associated with endometriosis pre- and post-diagnosis between January 2000 and November 2019. Articles were included if they were published in the US and reported one of the following types of costs: direct costs (drug costs, surgery costs, medical services costs, and other direct costs) or indirect costs.

RESULTS

: A total of 217 articles were initially identified from our search terms. After duplicates were removed and titles and abstracts screened, 19 remaining articles underwent full-text review. Among these 19 articles, seven publications met eligibility criteria and were included in this review. Variability in methodology, data sources, cost variables, and year cost estimates were reported, existed among studies. All studies included costs from a payor perspective and women diagnosed with endometriosis with mean ages ranging from 33.9 to 36.4 years. Two studies reported direct costs before diagnosis of endometriosis. Six studies reported direct costs after diagnosis. Three studies reported indirect and surgery costs after diagnosis. Before diagnosis, total direct costs ranged from $3,389 to $7,207. After diagnosis, total direct costs, indirect costs, and surgery costs ranged from $6,404 to $18,881, $60 to $6,237 and $3,422 to $13,302, respectively.

CONCLUSIONS

: Women diagnosed with endometriosis exhibit substantial cost burden, specifically after diagnosis. Future studies are needed to understand if diagnosing women earlier may result in a lower cost burden.