Burden of anemia in women with uterine fibroid-associated heavy menstrual bleeding.

Background: Uterine fibroids (UF) are commonly associated with heavy menstrual bleeding (HMB) and anemia; however limited data are available on the prevalence of anemia in women with UF, with or without HMB, and the additional incremental burden of HMB and anemia in women with UF and the associated costs of care are unclear. Objectives: To describe the clinical and economic burden of anemia in women diagnosed with UF, including those with HMB, compared with a control cohort of women without UF or HMB. Study Design: This was a retrospective observational study using claims data from the Merative MarketScan Commercial Database. The study included women aged 18-55 years newly diagnosed with UF. The first UF claim served as the index date, and women were followed over 12-month preindex and postindex periods. Patients with UF were categorized into cohorts based on the presence and order of HMB claims: UF only, UF then HMB (UF-HMB), and HMB then UF (HMB-UF). UF cohorts were then matched 1:1:1 on age. A control (non-UF/non-HMB) cohort comprising women with no claims for UF or HMB during the study period was identified and matched 5:1 to the 3 UF cohorts based on age. Cohorts were additionally classified based on the presence of anemia. Demographics were assessed at index; clinical characteristics, treatment characteristics for the UF cohorts, healthcare resource utilization, and cost outcomes were assessed during the preindex and postindex periods. Results: The study included 22,057 women in each UF cohort and 110,285 women in the control cohort. After age-based matching, mean (SD) age was 43.5 (5.9) years for all cohorts. Postindex anemia was most common in women in the UF-HMB (32.0%) and HMB-UF (35.3%) cohorts compared with the UF only (14.3%) and control (4.4%) cohorts. During the postindex period, procedures including hysterectomy and blood transfusions were more common in women with anemia (UF only: 13.4% and 1.8%, respectively; UF-HMB: 37.8% and 7.9%; HMB-UF: 40.8% and 5.7%) compared with women without anemia (UF only: 11.1% and 0%; UF-HMB: 28.1% and 0.1%; HMB-UF: 30.3% and 0%). All-cause and obstetrics/gynecology-related total costs were generally higher in women with anemia compared with women without anemia in all cohorts in both the preindex and postindex periods. Conclusions: This analysis underscores the significant clinical and economic burden of anemia in women with UF, as well as women with UF and HMB. The findings highlight the necessity for early detection and proactive management of UF and associated anemia to mitigate severe complications and reduce healthcare costs.