Economic burden and quality of life of vulvodynia in the United States

Objective: To explore the economic burden and quality of life of vulvodynia in the United States. Methods: We conducted a web-based survey from 2009 to 2010. Patients who responded to a National Vulvodynia Association advertisement completed the survey every month, recording their own costs and their employers' payments related to vulvodynia in the previous month. A total of 302 patients entered data for at least 1 month and among them, 97 patients had completed data for 6 months. We used multiple imputation to generate values for unobserved cost components. For insurance payments, we also extracted the average insurance payments for direct healthcare services relating to vulvodynia from a commercial insurance database. The total costs were disaggregated into direct healthcare costs, direct non-healthcare costs and indirect costs. We also assessed patients' quality of life by using Euro QOL 5 dimensions (EQ-5D) in a follow-up survey. Results: The total costs in 6 months were $8862.40 per patient, of which $6043.34 (68.19%) were direct healthcare costs, $553.81 (6.25%) were direct non-healthcare costs and $2265.25 (25.56%) were indirect costs. Based on the reported prevalence range of 3-7% in the US, our analysis yielded an annual national burden ranging from $31 to $72 billion in the US. However, the estimate should be viewed with caution as our study sample was non-probability. The average EQ-5D score was 0.74 +/- 0.19 in vulvodynia patients. Conclusion: Vulvodynia is associated with a huge economic burden to both individuals and society. It is also related to a relatively low quality of life.