Menopause drives costs both outside and inside hospital doors

Menopause is overwhelmingly under-diagnosed and under-treated, leading 1+ million patients to incur higher healthcare costs each year, a new study found.

Elektra Health, a telemedicine platform aimed at treating menopause, analyzed 2021 insurance claims data from 2.6 million women between the ages of 40 and 60, and compared the healthcare spending differences between patients who received a menopause-related ICD-10 diagnosis code to those who did not.

More than 1 million people in the US go through menopause each year, but only one in five (19%) receive a menopause diagnosis, according to the study. While menopause is often self-diagnosed, providers can use blood or urine tests to check hormone levels for confirmation.

However, a lack of ob-gyn menopause training has created a “massive care gap;” many patients seeking menopause care do not receive adequate treatment and instead turn to multiple specialists for care, the study found.

“Menopause costs are hiding in plain sight, and engaging women around their menopausal health has far-reaching implications,” Elektra cofounder and CEO Alessandra Henderson said in a statement. “In this way, menopause should be considered akin to other conditions driving significant costs, such as diabetes or hypertension.”

Only 20.8% of ob-gyn residents reported that their program had a menopause medicine training curriculum, according to a 2013 survey of 510 ob-gyn residents in the US published in The Journal of The North American Menopause Society. More than 60% of those surveyed reported having limited knowledge on aspects of menopause medicine, such as understanding how menopause symptoms progress and bone health.

Lack of providers trained in menopause medicine leads to “wasteful spending on specialty visits and tests,” per the Elektra study.

Patients with a menopause diagnosis spend $1,539 more per member per year (PMPY), or the average annual cost per patient, on clinical services and $1,963 more PMPY on outpatient treatment than those without a diagnosis, as well as hundreds of dollars more PMPY on inpatient care and prescriptions, the study found.

At the same time, menopause is linked to other costly health conditions such as joint and metabolic disorders.

Overall, people who’ve been diagnosed as menopausal spend 45% more on healthcare costs to treat their symptoms each year than those who are not menopausal, according to the study.

“Today, many menopausal women are seen by multiple specialists (e.g., neurology, psychiatry, cardiology) and undergo testing that may not be necessary nor recommended by the North American Menopause Society,” cofounder and COO Jannine Versi said in Elektra’s statement.

Menopause’s financial burdens follow patients outside the hospital doors.

Symptoms such as hot flashes and night sweats associated with menopause cost people in the US about $1.8 billion in lost working time each year, according to a Mayo Clinic study published last month.

However, things might be looking up in terms of menopause treatment. Last week, the FDA approved the first non-hormonal medication to treat hot flashes in menopausal women.

Although menopause has been historically underfunded in research, the market for menopause-focused companies is growing. By 2030, the global menopause market is expected to reach $24.4 billion, up from $16.9 billion in 2022, according to a report from market intelligence firm Grand View Research.