Elektra Health's Actuarial Cost Report Reveals Roughly 1 in 5 Women Are Clinically Diagnosed With Menopause By Providers

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May 16, 2023, 09:00 ET

Women with a diagnosis incurred 45% more healthcare costs compared to the benchmark.

NEW YORK, May 16, 2023 /PRNewswire/ -- Elektra Health, a next-gen digital health platform that empowers women navigating menopause with evidence-based virtual care, education, and peer support, today released their Actuarial Menopause Cost Report .^¹

Elektra's study is the first of its kind in a decade to investigate the healthcare costs incurred by menopausal women ages 40 to 60 according to actuarial analysis of claims data. The report is based on the 2021 MarketScan Commercial Claims data^² of 2.6 million women aged 40 to 60.

Key findings:

According to their insurance claims, only ~19% of women aged 40 to 60 received a clinical menopause diagnosis, even though up to 80% generally experience symptoms.^³
The population who received a clinical menopause diagnosis incurred 45% more healthcare costs, on average, per year.

The average cost in total healthcare expenses for the diagnosed population was $4,637 higher than non-diagnosed.
Outpatient services (labs, radiology, etc.) see a 62% cost increase between diagnosed and undiagnosed, while clinical services see a 52% increase.

For patients diagnosed with menopause, comorbid conditions such as metabolic disorders, hypertension, and joint pain are both more prevalent and costly compared to undiagnosed patients: 37% and $2,572, 14% and $4,133, 38% and $3,965, respectively.

50 million women are currently navigating menopause in the U.S. However less than 20% of OB/GYN residency programs offer menopause training.^⁴ This widespread lack of training — coupled with overburdened providers and enduring stigmas around menopause and aging — results in a massive care gap (70% of women who seek menopause care do not receive adequate treatment^⁵). Elektra's findings, along with existing research and patient experience, confirm that menopause remains overwhelmingly under-diagnosed and under-treated.

The report also underscores the close link between menopause and comorbid chronic conditions disproportionately impacting women, a link that has been established through decades of academic research.^{^6-⁷} The data suggest patients with menopause symptoms are sicker generally, driving higher incremental healthcare costs and utilization of services.

"Menopause costs are hiding in plain sight, and engaging women around their menopausal health has far-reaching implications," says Alessandra Henderson, Co-Founder & CEO at Elektra. "With proper menopause care, we can engage women around broader preventative health and chronic conditions, which worsen over time. In this way, menopause should be considered akin to other conditions driving significant costs, such as diabetes or hypertension."

Nathan Kleinman, PhD, is the principal author of the 2013 study, "Direct and indirect costs of women diagnosed with menopause symptoms",^⁸ one of the most significant papers written on the subject to date. He said, "The results of the new Elektra study on the cost differences between women with and without diagnosed menopause symptoms are compelling and highlight the need for additional focus and care in this area. This need has grown over the decade since our study on this topic was published."

"This study builds on past research on the economic impact of menopause but only scratches the surface. We must collaborate with all stakeholders – patients, health plans, providers – to better address patients' symptoms and the risk of chronic conditions, and improve access to informed care," says Jannine Versi, Co-Founder & COO at Elektra. "Today, many menopausal women are seen by multiple specialists (e.g., neurology, psychiatry, cardiology) and undergo testing that may not be necessary nor evidence-based according to the North American Menopause Society.^⁹ Elektra's care model is built by menopause-trained gynecologists to address the root cause of such symptoms, thus improving health outcomes and reducing costs in this time of transition and for decades beyond."

Elektra worked with Accorded, an actuarial intelligence company, on this study. While, on an individual level, diagnosis codes on an insurance claim don't necessarily equate to delivery of appropriate care and treatment — and vice versa — claims data in aggregate are helpful indicators of healthcare costs and utilization associated with diagnoses at the population level.

To read the findings in full, please visit: elektrahealth.com/actuarial-menopause-cost-report/.

About Elektra Health

Elektra empowers the 50+ million women currently navigating menopause with an integrative, evidence-based care model. Elektra pairs peer support and MD-vetted education with convenient telemedicine care from board-certified clinicians. Backed by leading investors Flare Capital Partners and Alexis Ohanian's 776 fund, Elektra works with top employers and health plans across the U.S. to offer people experiencing menopause the care they deserve. To learn more, please visit elektrahealth.com.

Contact
Kathy Osborne
607-434-2065
[email protected]

^¹ Elektra Health worked with Accorded, a healthcare actuarial firm, to rigorously examine the cost and prevalence claims data associated with patients receiving a clinical diagnosis of menopause and associated comorbid conditions.
^² Merative™ MarketScan® Commercial Claims Database provides one of the longest-running and largest collections of proprietary de-identified claims data for privately and publicly insured people in the U.S. The Commercial Claims Database includes over 25M members' eligibility and claims data from employer-sponsored plans.
^³ Santoro N, et al. Menopausal Symptoms And Their Management. Endocrinol Metab Clin North Am. 2015; 44(3): 497 - 515. doi: 10.1016/j.ecl.2015.05.001.
^⁴ Christianson M, et al. Menopause education: needs assessment of American obstetrics and gynecology residents. Menopause. 2013;20(11):1120-5. doi:10.1097/GME.0b013e31828ced7f
^⁵ Sarrel P, et al. Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause. 2015;22(3):260-266. doi:10.1097/GME.0000000000000320
^⁶ Anagnostis P, Lambrinoudaki I, Stevenson J, Goulis D. Menopause-associated risk of cardiovascular disease. Endocr Connect. 2022; 11(4):e210537. doi:10.150/EC-21-0537.
^⁷ Ji M, et al. Primary osteoporosis in postmenopausal women. Chronic Dis Transl Med. 2015; 1(1): 9-13. doi: 10.1016/j.cdtm.2015.02.006.
^⁸ Kleinman N, et al. Direct and indirect costs of women diagnosed with menopause symptoms. J Occup Environ Med. 2013; 55(4): 465-470. doi: 10.1097/JOM.0b013e3182820515.
^⁹ NAMS Position Statement. Menopause. 2022; 29(7): 767-794. doi: 10.1097/GME.0000000000002028