Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost-utility analysis of the FEMME trial.
Cost-effectiveness
economic evaluation
myomectomy
uterine artery embolisation
uterine fibroids
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
accepted:
19
04
2021
pubmed:
31
5
2021
medline:
29
9
2021
entrez:
30
5
2021
Statut:
ppublish
Résumé
To assess the cost-effectiveness of uterine artery embolisation (UAE) and myomectomy for women with symptomatic uterine fibroids wishing to avoid hysterectomy. Economic evaluation alongside the FEMME randomised controlled trial. 29 UK hospitals. Premenopausal women who had symptomatic uterine fibroids amenable to UAE or myomectomy wishing to avoid hysterectomy. 254 women were randomised to UAE (127) and myomectomy (127). A within-trial cost-utility analysis was conducted from the perspective of the UK NHS. Quality-adjusted life years (QALYs) measured using the EuroQoL EQ-5D-3L, combined with costs to estimate cost-effectiveness over 2 and 4 years of follow-up. Over a 2-year time horizon, UAE was associated with higher mean costs (difference £645; 95% CI -1381 to 2580) and lower QALYs (difference -0.09; 95% CI -0.11 to -0.04) when compared with myomectomy. Similar results were observed over the 4-year time horizon. Thus, UAE was dominated by myomectomy. Results of the sensitivity analyses were consistent with the base case results for both years. Over 2 years, UAE was associated with higher costs (difference £456; 95% CI -1823 to 3164) and lower QALYs (difference -0.06; 95% CI -0.11 to -0.02). Myomectomy is a cost-effective option for the treatment of uterine fibroids. The differences in costs and QALYs are small. Women should be fully informed and have the option to choose between the two procedures. Fully informed women with uterine fibroids should have a choice between uterine artery embolisation or myomectomy.
Identifiants
pubmed: 34053154
doi: 10.1111/1471-0528.16781
doi:
Banques de données
ISRCTN
['ISRCTN70772394']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1793-1802Subventions
Organisme : National Institute of Health Research (NIHR) Health Technology Assessment Programme
ID : 08/53/22
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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