Evidence / Health Economics

Menopause NHS Pathway Economic Model

Methodology, assumptions and limitations underpinning Jackson FutureMed’s scenario analysis of additional primary-care resource use associated with repeat GP consultations in menopause care.

Scenario analysisEnglandNHS primary careGBPVersion 1.0Reviewed Sep 2026

Evidence status

This model does not estimate savings attributable to Mena.

It is an illustrative resource-use model designed to quantify the scale of additional GP consultation activity under defined assumptions. Any effect of Mena on NHS activity, outcomes or costs would need to be established through prospective evaluation.

Model summary

What the model estimates

The model combines a NICE-derived proxy care-seeking population, a Fawcett Society multiple-appointment rate, and a published GP consultation unit cost.

Low scenario

£17.0m

1 additional GP consultation

Central scenario

£34.0m

2 additional GP consultations

High scenario

£51.1m

3 additional GP consultations

Figures are scenario outputs rather than observed NHS expenditure or predicted Mena savings.

Method

How the model is constructed

Four explicit steps connect published evidence to the scenario outputs.

Proxy care-seeking population

NICE TA1143

1,220,107 women in the defined symptomatic care-seeking population.

Multiple-appointment parameter

Fawcett Society

31% of GP-approaching respondents reported that recognition took many appointments.

Additional-visit scenarios

JFM assumption

Because the source does not report a distribution, JFM tests 1, 2 and 3 additional visits.

GP resource cost

Published unit cost

£45 per 10-minute GP surgery consultation.

1,220,107 × 31% ≈ 378,233 people in the modelled subgroup before the additional-visit scenarios are applied.

Calculation

The model equation

All outputs can be reproduced directly from four inputs.

Modelled GP resource use

NICE-derived proxy care-seeking population × Multiple-appointment rate × Additional consultations × GP unit cost

1,220,107 × 31% × 1–3 × £45

1,220,107

NICE-derived proxy care-seeking population

31%

Multiple-appointment rate

1 / 2 / 3

Additional GP visits

£45

GP consultation cost

Inputs

Inputs and source evidence

Three published inputs feed the model. The additional-visit count is a JFM sensitivity assumption.

Proxy care-seeking population

1,220,107

NICE TA1143 resource-impact analysis

Women aged 40–65 with moderate-to-severe menopause-associated vasomotor symptoms (VMS) who NICE estimates seek medical intervention or advice.

Multiple appointments

31%

Fawcett Society, 2022

Among respondents who had approached their GP surgery, 31% said recognition of menopause or perimenopause took many appointments.

GP unit cost

£45

Unit Costs of Health and Social Care 2024

Resource cost for a 10-minute GP surgery consultation including direct-care staff and qualification costs.

Population

How the 1,220,107 population is derived

The denominator comes from the NICE TA1143 resource-impact analysis and is used here as a proxy care-seeking population.

Population step	Value
Women aged 40–65 in England	9,923,630
Prevalence of moderate-to-severe vasomotor symptoms	21.10%
Women with moderate-to-severe vasomotor symptoms	2,093,886
Proportion seeking medical intervention or advice	58.27%
Model population	1,220,107

Why this population?

Vasomotor symptoms (VMS) — principally hot flushes and night sweats — are common menopause-associated symptoms. NICE TA1143 provides a transparent England-wide pathway from women aged 40–65, through moderate-to-severe VMS, to those seeking medical intervention or advice.

JFM uses the 1,220,107 care-seeking stage as a proxy denominator. We do not use NICE’s later fezolinetant-specific 366,032 eligibility population, and 1,220,107 is not an estimate of all women seeking menopause care.

Population assumption

The NICE population is not a published count of women making menopause-related GP consultations in a single year. Its use as the denominator in this GP consultation scenario model is therefore a Jackson FutureMed modelling assumption.

Transfer assumption

How the 31% parameter is used

The Fawcett result is used as a scenario parameter rather than as a directly observed national rate across the NICE population.

NICE TA1143

1,220,107

Women aged 40–65 with moderate-to-severe VMS seeking medical intervention or advice.

Fawcett Society, 2022

31%

Among surveyed menopausal/perimenopausal women who had approached their GP surgery, 31% reported that recognition took many appointments.

Population comparability

The populations are related but not identical. Applying the 31% rate to the NICE-derived population is the model’s principal transfer assumption and should be interpreted accordingly.

Scenarios

Why the model uses one, two and three additional visits

Fawcett establishes that some respondents required multiple appointments before recognition, but it does not report the average or distribution of additional consultations.

Low

additional consultation

Central

additional consultations

High

additional consultations

Why one, two and three?

Because the source evidence says recognition took “many appointments” but does not quantify the number of additional consultations, JFM uses one, two and three additional visits as a simple bounded sensitivity range. These are modelling assumptions, not observed national averages.

The two-visit central scenario is illustrative; it is not presented as the expected, average or most likely value.

At the 31% parameter and £45 unit cost, each additional assumed consultation adds approximately £17.0m to modelled resource use.

Outputs

Scenario results

The table below reproduces the modelled £17m–£51m range from the defined inputs.

Scenario	Additional visits	Modelled consultations	Unit cost	Resource use
Low	1	378,233	£45	£17.0m
Central	2	756,466	£45	£34.0m
High	3	1,134,700	£45	£51.1m

Low

1,220,107 × 0.31 × 1 × £45

£17,020,492.65

Central

1,220,107 × 0.31 × 2 × £45

£34,040,985.30

High

1,220,107 × 0.31 × 3 × £45

£51,061,477.95

Scope of this estimate

The model considers only the defined NICE-derived symptomatic care-seeking population and the resource value of additional GP consultations. It does not include all people seeking menopause care, other symptom presentations, diagnostic activity, prescriptions, referrals or secondary-care costs.

Because the denominator and 31% parameter come from different evidence populations, the output should not be described as a definitive lower-bound or “conservative” national estimate.

Sensitivity

How the central result changes if the multiple-appointment rate changes

Population, two additional visits and the £45 unit cost are held constant.

20%£22.0m

25%£27.5m

31%£34.0m

35%£38.4m

40%£43.9m

Holding the population, two-visit scenario and £45 cost constant, each one-percentage-point change in the multiple-appointment rate changes modelled resource use by approximately £1.10m. The range illustrates sensitivity to assumptions; it is not a probability distribution.

Interpretation

What the model can and cannot support

The model can support

Illustrating the scale of repeat primary-care activity
Health-economic study design
Sensitivity analysis
Identification of variables for prospective NHS evaluation

The model does not establish

Observed current NHS expenditure
That all repeat consultations are avoidable
That Mena would remove the modelled consultations
That Mena would save £17m–£51m
That the 31% rate applies exactly to the NICE population

Scope

Included and excluded from the model

Included

GP consultation activity
Defined population scenario
Multiple-appointment parameter
Assumed additional consultations
Average GP consultation resource cost

Not included

Testing, prescriptions and medicines
Nurse, pharmacy and specialist activity
Secondary-care activity
Employer and patient costs
Mena implementation costs
Any Mena intervention effect

The model should not be interpreted as an estimate of the total NHS or economic burden of menopause.

Context

Other figures referenced in JFM materials

The figures below may appear in other Jackson FutureMed materials, but they are separate contextual analyses rather than inputs to this primary-care resource-use model. They use different populations, methods and time periods, and should not be added to or treated as alternative estimates of the £17m–£51m outputs on this page.

~£1.7bn

Wider economic impact

Menopause-related unemployment, absence and presenteeism.

£500m+

National pathway opportunity

Government-cited scenario modelling for an optimal menopause care pathway.

~£9.6m

Historic diagnostic-testing model

Historic NICE modelling of FSH testing cost reduction.

These external contextual figures are not inputs to the JFM model and are not additive to its £17m–£51m scenario outputs.

Methodological caveats

Key assumptions and limitations

Key assumptions

NICE-derived care-seeking population is an appropriate proxy
Fawcett 31% can be used as a scenario parameter
One, two and three additional visits are reasonable sensitivity scenarios
£45 is an appropriate average resource-cost proxy
All additional consultations are assigned the same unit cost
A one-year resource-use framing is used
No Mena effect is assumed

Principal limitations

Population matching between NICE and Fawcett
Self-reported survey evidence
Unknown national distribution of excess visits
Annualisation of a care-seeking population
Average rather than marginal consultation cost
No assessment of clinical necessity or avoidability
Deterministic rather than probabilistic modelling
No intervention effect

The model should therefore be interpreted as transparent scenario analysis rather than a budget-impact forecast.

Next evidence step

How the model could be validated in an NHS evaluation

Prospective data can replace assumptions with observed pathway activity and support attribution of any resource effect.

Baseline

Measure current menopause-related pathway activity

Deploy

Introduce Mena within a defined evaluation design

Compare

Measure repeat contacts, testing, referrals, outcomes and clinician time

Attribute

Estimate any incremental resource effect attributable to the intervention

A controlled or appropriately designed comparative evaluation would be required to estimate whether Mena changes these outcomes and to attribute any resource effect to the intervention.

Sources

Core model inputs and contextual evidence

Core model inputs

Contextual evidence