Health Utility, Work Productivity, and Total Economic Burden of Polycystic ovary syndrome (PCOS/PMOS)

Abstract Background Polycystic Ovary Syndrome (PCOS), also known as Polyendocrine metabolic ovarian syndrome (PMOS), impairs health-related quality of life (QoL) and daily functioning. While estimates of medical-related costs have been made, this study aimed to estimate indirect (work productivity-related) and intangible (QoL-related) economic costs. Methods In a cross-sectional U.S. registry (PCOS/PMOS=433, controls=252), we measured willingness-to-pay (WTP), health utility using the EQ-5D-5L and SF-6D tools, and work productivity with WPAI-GH. Adjusted regression estimated utility differences were converted to Quality-Adjusted Life Year (QALY) loss. XGBoost classification with SHAP feature importance identified key discriminating domains. Results PCOS/PMOS had lower health utility compared to controls (EQ-5D-5L: 0.72 vs. 0.88; SF-6D: 0.67 vs. 0.72; p<0.001), corresponding to QALY losses of 0.12 and 0.04, respectively. Annual intangible costs per woman were then estimated to be $12,000 (per EQ-5D-5L) or $4,000 (per SF-6D). Median work productivity loss for PCOS/PMOS was 39.5% vs. 6.0% for controls (using $37/hr. and 2080 hr./yr). Considering the number of women with PCOS/PMOS in the U.S., the total yearly indirect cost was estimated to be $97.9 billion and yearly intangible cost was estimated to range from $17.8 billion (by SF-6D) to $53.4 billion (by EQ-5D-5L), in 2026 USD. Machine learning identified pain, anxiety/depression, and physical functioning limitations as key discriminators. Conclusions PCOS/PMOS is associated with lower utility, significant QALY losses, work productivity impairment. Considering prior estimates of medical-related costs, a total nearly $133-169 billion annual U.S. societal burden, predominantly from indirect and intangible costs, underscoring profound functional and economic impact of the disorder.