OBJECTIVES : Endometriosis affects about 176 million women worldwide, leading to abdominal pain and infertility. This study aims to describe treatment patterns and costs for uterus endometriosis (UE), from the Brazilian public perspective.

METHODS : Retrospective analysis of hospitalizations and treatment profile reported for UE was developed according to ICD-10 codes (N80.0) as described in Brazilian Information System (SIH/SUS-SIA/SUS) database from January/2008 to August/2019. Costs represent federal reimbursement values for hospitalizations (medical procedures, exams, drugs, fees), and drugs dispensed in an outpatient scenario, estimated in 2019 Brazilian Real (BRL). Although considered a treatment, oral contraceptives are not recorded in the database, so their utilization patterns and costs are not considered in this analysis.

RESULTS : A total of 29,322 outpatients and 83,766 inpatients were included, with an overall cost of 93,081,503BRL for all years. Goserelin was the most dispensed drug (27,115 patients; 92.5%) and hysterectomy with uni/bilateral adnexectomy the most applied procedure (26,601; 31.8%), together representing 65% of total cost (more than 60 million BRL).

Regarding outpatients, a decrease in the number of treated women over the years was observed, from 4,955 in 2008 to 1,225 in 2019. Most were in the southeast Brazilian region (20,883; 71.2%), mainly in São Paulo (17,693; 60.3%). Besides goserelin (92.5%), triptorelin (0.8%), leuprorelin (6.6%) and danazol (0.9%) were also dispensed, and the same patient may have received more than one medication. The total cost of drugs was 37,263,506BRL (95.0%), 225,018BRL (0.6%), 1,514,510BRL (3.9%) and 211,995BRL (0.5%), respectively.

For inpatients, the number of hospitalizations decreased from 7,136 in 2008 to 3,793 in 2019. Similarly, costs decreased from 4 million BRL to 2 million BRL, respectively.

CONCLUSIONS : Despite cost reduction and decreased number of patients over the years, UE remains a health issue in Brazilian public healthcare system. Further research could clarify causes of such reductions.