COSTS OF GLOBAL ENDOMETRIAL ABLATION (GEA) FOR TREATMENT OF HEAVY MENSTRUAL BLEEDING (MENORRHAGIA)- ASSIMILATION AND COMPARISON OF RESULTS FROM PUBLISHED COST-EFFECTIVENESS MODELING STUDIES

Author(s)

Miller JD* Truven Health Analytics, Cambridge, MA, USA

OBJECTIVES: Most cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of heavy menstrual bleeding (menorrhagia) are from a UK perspective.  Costs and cost-effectiveness information about GEA from a US perspective are lacking.  Study objectives were: 1) identify/review all cost-effectiveness modeling studies of GEA; 2) assimilate GEA costs across these studies at current levels (2012 US dollars) to proxy a US market perspective; and 3) perform statistical summarizations of the data. METHODS: All published literature and health technology assessments of menorrhagia treatment cost-effectiveness published 2004-2012 were reviewed; studies with GEA as a comparator were selected for inclusion.  GEA cost data were abstracted and converted to US dollars using purchasing power parity indices (PPPI) and adjusted to 2012 levels using the US consumer price index (CPI).  Statistical summarizations (minimum, maximum, mean, median) were performed for studies in their respective 1-, 2-, 5-, and 10-year analysis scenarios. RESULTS: From a total of eight cost-effectiveness modeling studies, 14 GEA cost data values were abstracted.  All values pertained to either microwave endometrial ablation (MEA) or thermal balloon endometrial ablation (TBEA), or a composite weighted average of the two techniques.  No studies reported costs associated with cryoablation, bipolar radiofrequency ablation, or hydrothermal ablation (HTA).  Adjusted GEA costs from two 1-year analyses ranged from $1,011 to $1,329 (mean/median $1,170).  Costs from a single 2-year analysis were $2140.  Costs from four 5-year analyses ranged from $2700 to $3748 (mean $3359, median $3493).  Costs from seven 10-year analyses ranged from $2495 to $4549 (mean $3264, median $3119). CONCLUSIONS: There was a large degree of heterogeneity in scope and comprehensiveness of cost accounting in the GEA cost analyses summarized here. Although only proxy estimates of GEA costs in the US, results of this study serve as useful benchmarks for cost evaluations of GEA in the dramatically changing menorrhagia-treatment market.

Conference/Value in Health Info

2013-05, ISPOR 2013, New Orleans, LA, USA

Value in Health, Vol. 16, No. 3 (May 2013)

Code

PIH18

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Reproductive and Sexual Health, Systemic Disorders/Conditions

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