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The
present cost-effectiveness analysis suggests that therapy with GnRH-a for six
months is a pocket-friendly choice for preventing recurrence of endometriosis.
Endometriosis is a diseased condition where the endometrium grows outside the uterus at some abnormal sites like pelvic peritoneum, ovaries, fallopian tubes, bladder and bowel. It is characterized by abdominal pain, heavy periods, and infertility. Medical and surgical options are available to help reduce your symptoms.
The study was performed to evaluate the cost-effectiveness of different strategies for endometriosis therapy. These strategies include gonadotropin-releasing hormone agonist (GnRH-a) and oral contraceptive therapy, which is used to prevent the recurrence of endometriosis after conservative surgery.
This current study was designed as a cost-effectiveness analysis from a health care perspective, with the health-resource-limited setting in China. It included patients who had gone through conservative laparoscopic or laparotomic surgery for endometriosis.
For performing this study, a Markov model was used to analyze the endometriosis disease course. Clinical data were collected from published studies. Direct medical costs and resource utilized in the Chinese healthcare setting were also taken into account. Evaluation of health and economic outcomes was done starting from the period of treatment initiation to menopause onset. Sensitivity analyses were performed to find out the impact of various parameters and assumptions on the model output.
The outcome to measure was like Quality-adjusted life years (QALYs) gained and
costs from a healthcare perspective. Therefore the findings estimated that the incremental cost-effectiveness ratio
of 6-month GnRH-a therapy when compared with no treatment, ranged from $6,185
per QALY in deep endometriosis to $6,425 with peritoneal endometriosis. A
one-way sensitivity analysis calculated significant influential factors, like
remission rates and utility values. Probabilistic sensitivity analysis revealed
that 6-month GnRH-a therapy is cost-effective in most cases at a threshold of
$7,400/QALY, regardless of the type of endometriosis.
BJOG. 2017 Jun 14.
Medical therapy for preventing recurrent endometriosis after conservative surgery: a cost-effectiveness analysis
B Wu et al.
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