Macromastia: an economic burden? A disease cost analysis based on real-world data in Germany
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GENERAL GYNECOLOGY
Macromastia: an economic burden? A disease cost analysis based on real‑world data in Germany Sebastian M. Jud1 · Anne Brendle‑Behnisch1 · Carolin C. Hack1 · Caroline Preuss1 · Andreas Arkudas2 · Raymund E. Horch2 · Matthias W. Beckmann1 · Michael P. Lux3 Received: 10 August 2020 / Accepted: 13 October 2020 © The Author(s) 2020
Abstract Purpose Symptomatic macromastia causes physical and psychological problems that can lead to restrictions in the patients’ social and working lives and a reduced quality of life. Associated medical treatments also have a considerable impact on health-care costs. Several studies have assessed these costs, but the total disease costs of macromastia have never been evaluated on the basis of real-world data. Methods The data for 76 patients who underwent reduction mammoplasty between 2008 and 2016 were collected using a two-part questionnaire (preoperative and postoperative), as well as the patient files. Topics surveyed, besides demographic data, included physician visits, medical imaging, medical procedures, medical treatments, rehabilitation and convalescent measures, drug intake, medical aids, exercise activity, and sick leave days before surgery, to calculate the costs per year of conservative treatment of symptomatic macromastia. Results The mean time from start of symptoms to surgery was 11.82 years. The data for this group of patients with symptomatic macromastia show that costs per patient amount to €1677.55 per year. These costs include medical consultation, radiological imaging, medical treatments and procedures, physical therapy and rehabilitation, medication, special brassieres, exercise classes costs for sick leave due to problems with macromastia, and travel expenses. Conclusions These results show that considerable health-care costs arise due to macromastia with conservative treatment. Overall, macromastia costs €1677.55 per patient/year. In particular, lost productivity due to sick days and the costs of physiotherapy are factors driving the high costs. Keywords Macromastia · Gigantomastia · Disease costs · Conservative treatment · Health care · Breast reduction mammoplasty
Introduction
* Michael P. Lux [email protected] 1
Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Erlangen, Germany
2
Department of Plastic Surgery and Hand Surgery, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Erlangen, Germany
3
Department of Gynecology and Obstetrics, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Frauen- Und Kinderklinik St. Louise, St. Vincenz GmbH, Husener Strasse 81, 33098 Paderborn, Germany
There is no unique definition of macromastia. There are several different synonyms for it, such as gigantomastia and hyperplasia of the mammary gland. Macromastia is usually defined as excessive growth of the mammary gland beyond the normal range [1]. However, what is normal always lies in the eye of the beho
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