Cost analysis of hospital-based symptomatic uterine fibroids in the kingdom of Eswatini: A prevalence-based cost-of-illness study

Background: Uterine fibroids are common benign tumours of uterine smooth muscle. It has been established that uterine fibroids cause a marked global financial burden on healthcare systems and society; however, significant gaps exist in the knowledge of costs related to uterine fibroids. This study aimed to estimate costs associated with the diagnosis, care, and management of uterine fibroids in Eswatini. Methods: The study employed the Cost of Illness (COI) method, a retrospective prevalence cost model. The provider’s perspective was used to estimate all identifiable direct medical costs of UFs. Data was collected from participants’ charge and claims records from the hospitals between 21 August 2021 and 21 August 2022. The study employed a bottom-up approach to estimate all patient costs related to uterine fibroids care and treatment. The costs were calculated at the 2022 price level and converted to United States dollars (USD) using private-payer prices. Results: The total annual direct medical cost of uterine fibroids in Eswatini was estimated at USD 837894.60. This includes the total estimated costs of outpatient treatment and care, surgical treatment and care, and inpatient treatment and care. The key cost drivers were surgical and inpatient costs, USD 421583.18 and USD 110716.59, respectively. Conclusion: The total annual cost estimation of uterine fibroids care is significantly high, with the majority of the cost related to theatre and hospitalisation charges. Understanding these financial implications can help guide healthcare policies and resource management.