Postmenopausal hormone therapy increases use of health services: Experience from the Estonian Postmenopausal Hormone Therapy Trial [ISRCTN35338757]

Objective This study was undertaken to compare utilization of health services and health care costs in a randomized hormone therapy trial. Study design A total of 1823 healthy postmenopausal women aged 50 to 64 years at the time of sampling were allocated to combined continuous hormone therapy or placebo or no treatment. The analysis was based on routinely collected electronic data in the Estonian Health Insurance Fund database during a follow-up period from 2 to 5 years. Results In the nonblind subtrial, the number of all health care visits was 10% higher and the number of visits to family practitioners 16% higher per person-year in the hormone therapy arm. Per person-year, the number of vaginal sonograms was 14% and the number of electrocardiograms 19% higher in the nonblind hormone therapy arm. Outpatient health care costs and drug expenses were higher in the nonblind hormone therapy arm. In the blind subtrial, the number of gynecologic operations, vaginal sonograms and total health care costs was higher in the hormone therapy arm. Conclusion Hormone therapy caused additional expenses on health care.