Journal of the Endocrine Society · 2026
Health utility, work productivity, and total economic burden of polycystic ovary syndrome.
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Amiri Mina, Huang Yucheng, Thai Linda, Ottey Sasha, Patterson William, Delau Olivia R, Yadav Surabhi, Soucie Kendall, Partridge Ty, Buyalos Richard P, Azziz Ricardo
Аннотация
BACKGROUND: Polycystic ovary syndrome (PCOS), also known as polyendocrine metabolic ovarian syndrome (PMOS), impairs health-related quality of life (QoL) and daily functioning. While estimates of medical-related costs have been made, this study aimed to estimate indirect (work productivity-related) and intangible (QoL-related) economic costs.
METHODS: In a cross-sectional US registry (PCOS/PMOS = 433, controls = 252), we measured willingness to pay, health utility using the EuroQol five-dimension five-level (EQ-5D-5L) and the Short Form 6-Dimensions (SF-6D) tools, and work productivity with Work Productivity and Activity Impairment: General Health. Adjusted regression estimated utility differences were converted to quality-adjusted life year (QALY) loss. XGBoost classification with Shapley Additive exPlanations feature importance identified key discriminating domains.
RESULTS: PCOS/PMOS had lower health utility compared to controls (EQ-5D-5L, 0.72 vs 0.88; SF-6D, 0.67 vs 0.72; P < .001), corresponding to QALY losses of 0.12 and 0.04, respectively. Annual intangible costs per woman were then estimated to be $12 000 (per EQ-5D-5L) or $4000 (per SF-6D). Median work productivity loss for PCOS/PMOS was 39.5% vs 6.0% for controls (using $37/hour and 2080 hours/year). Considering the number of women with PCOS/PMOS in the United States, the total yearly indirect cost was estimated to be $97.9 billion, and yearly intangible cost was estimated to range from $17.8 billion (by SF-6D) to $53.4 billion (by EQ-5D-5L), in 2026 USD. Machine learning identified pain, anxiety/depression, and physical functioning limitations as key discriminators.
CONCLUSION: PCOS/PMOS is associated with lower utility, significant QALY losses, and work productivity impairment. Considering prior estimates of medical-related costs, the total annual US Societal burden ranges from $133 to $169 billion, predominantly from indirect and intangible costs, underscoring the profound functional and economic impact of the disorder.
METHODS: In a cross-sectional US registry (PCOS/PMOS = 433, controls = 252), we measured willingness to pay, health utility using the EuroQol five-dimension five-level (EQ-5D-5L) and the Short Form 6-Dimensions (SF-6D) tools, and work productivity with Work Productivity and Activity Impairment: General Health. Adjusted regression estimated utility differences were converted to quality-adjusted life year (QALY) loss. XGBoost classification with Shapley Additive exPlanations feature importance identified key discriminating domains.
RESULTS: PCOS/PMOS had lower health utility compared to controls (EQ-5D-5L, 0.72 vs 0.88; SF-6D, 0.67 vs 0.72; P < .001), corresponding to QALY losses of 0.12 and 0.04, respectively. Annual intangible costs per woman were then estimated to be $12 000 (per EQ-5D-5L) or $4000 (per SF-6D). Median work productivity loss for PCOS/PMOS was 39.5% vs 6.0% for controls (using $37/hour and 2080 hours/year). Considering the number of women with PCOS/PMOS in the United States, the total yearly indirect cost was estimated to be $97.9 billion, and yearly intangible cost was estimated to range from $17.8 billion (by SF-6D) to $53.4 billion (by EQ-5D-5L), in 2026 USD. Machine learning identified pain, anxiety/depression, and physical functioning limitations as key discriminators.
CONCLUSION: PCOS/PMOS is associated with lower utility, significant QALY losses, and work productivity impairment. Considering prior estimates of medical-related costs, the total annual US Societal burden ranges from $133 to $169 billion, predominantly from indirect and intangible costs, underscoring the profound functional and economic impact of the disorder.