OBJECTIVES: Endometriosis (EM) affects ~10% of reproductive-aged women with the most frequent symptom being pain. Surgery is common, although not always curative. Hormonal therapy and analgesics are used to treat EM-related pain. With recent approvals of two GnRH antagonists indicated for EM-associated pain, it is important to review clinical burden and health care resource utilization (HCRU) of women with EM (wEM).

METHODS: A cross-sectional retrospective analysis of administration claims from the Merative-Marketscan database was conducted to compare wEM versus age-matched controls in 2021. Active patients were self-identified females, aged 18-55 years, with 2 EM diagnoses and continuous enrollment during the study period. Descriptive statistics were utilized to report characteristics/demographics and HCRU.

RESULTS: The 2021 cohort included 15,228 wEM, and 37,596 controls; mean age was approximately 36 years. wEM were more likely than controls (wEM v. C) to report EM-associated pain symptoms: abdominal discomfort (52%, 11%); pelvic (51%, 10%); non-menstrual pelvic (40%, 9%); abnormal bleeding (25%, 7%); and, dyspareunia (12%, 1%). wEM were more likely to be treated with oral contraceptives (30%, 18%), GnRH antagonists (10%, 0%), oral progestins (5%, 1%), or opioids (52%, 14%). Also, EM patients had higher rates of infertility (10%,1%), hysterectomies (14%, 0%), laparoscopies (20%, 0%), and ablation (2%, 0%) compared to controls.

Across all treatment categories, wEM incurred an average of ~3x greater healthcare resource utilization (HCRU) compared to controls ($20,381, $7,000). The greatest mean expenditures were for outpatient procedures ($8,045, $3,406), followed by total pharmacy ($3,387, $1,676).

CONCLUSIONS: In this 2021 cross-sectional analysis, wEM experienced greater pain and HCRU than controls. Although not curative, surgical procedures were frequently performed, while FDA-approved medications for EM-associated pain were infrequently used. New pharmacologic therapies for EM-associated pain may help reduce the clinical and humanistic burden of this very prevalent illness in women.