Healthcare utilization and costs in women diagnosed with endometriosis before and after diagnosis: a longitudinal analysis of claims databases  Mahesh Fuldeore, Ph.D., Hongbo Yang, Ph.D., Ella Xiaoyan Du, M.E.Sc., Ahmed M. Soliman, Ph.D., Eric Q. Wu, Ph.D., Craig Winkel, M.D.  Fertility and Sterility  Volume 103, Issue 1, Pages 163-171 (January 2015) DOI: 10.1016/j.fertnstert.2014.10.011 Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Flowchart of sample selection of endometriosis and control patients. Patients with endometriosis were included in this study if they satisfied the following criteria: were female; had at least one confirmed endometriosis diagnosis (ICD-9 code of 617.xx); were continuously enrolled in their healthcare plan for at least 1 year before and at least 1 year after the index date; and were between 18 and 45 years old. Patients with endometriosis were 1:1 matched to control patients (women without endometriosis during the study period) according to age, region, and insurance type. The controls were assigned the same index dates as their paired endometriosis patients. Cohort size varied every year owing to the requirement that patients and controls must be continuously enrolled in their healthcare plan during the time period studied. Fertility and Sterility 2015 103, 163-171DOI: (10.1016/j.fertnstert.2014.10.011) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Economic costs of endometriosis. (A) Annual medical service costs for women with endometriosis (blue bars) vs. controls (red bars). (B) Annual prescription drug costs for women with endometriosis (blue bars) vs. controls (red bars). (C) Annual total healthcare costs for women with endometriosis (blue bars) vs. controls (red bars). Costs were calculated from a payer perspective, and report per patient per year costs incurred during 2000–2010 and inflation-adjusted to 2010 USD. Fertility and Sterility 2015 103, 163-171DOI: (10.1016/j.fertnstert.2014.10.011) Copyright © 2015 American Society for Reproductive Medicine Terms and Conditions