Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids
Objective To estimate the cost‐effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance‐guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy. Design Cost‐...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2008-04, Vol.115 (5), p.653-662 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Zowall, H Cairns, JA Brewer, C Lamping, DL Gedroyc, WMW Regan, L |
| description | Objective To estimate the cost‐effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance‐guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy.
Design Cost‐utility analysis based on a Markov model.
Setting National Health Service (NHS) Trusts in England and Wales.
Population Women for whom surgical treatment for uterine fibroids is being considered.
Methods The parameters of the Markov model of the treatment of uterine fibroids are drawn from a series of clinical studies of MRgFUS, and from the clinical effectiveness literature. Health‐related quality of life is measured using the 6D. Costs are estimated from the perspective of the NHS. The impact of uncertainty is examined using deterministic and probabilistic sensitivity analysis.
Main outcome measures Incremental cost‐effectiveness measured by cost per quality‐adjusted life‐year (QALY) gained.
Results The base‐case results imply a cost saving and a small QALY gain per woman as a result of an MRgFUS treatment strategy. The cost per QALY gained is sensitive to cost of MRgFUS relative to other treatments, the age of the woman and the nonperfused volume relative to the total fibroids volume.
Conclusions A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost‐effective. |
| doi_str_mv | 10.1111/j.1471-0528.2007.01657.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2344162</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70386221</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5307-29fe11c2f6dd96466277f70ba8668c63e7fa57b852bfd2d051edd503d4c6d0783</originalsourceid><addsrcrecordid>eNqNkctu1DAUhiMEoqXwCihiwS7Bl8T2LECCEVdV6gbWlmMfDx4l9mDHpbPjEfqMfRKczqhcNuDNOdL_nV_H56-qGqMWl_di2-KO4wb1RLQEId4izHreXt2rTu-E-7c9ahAl4qR6lNIWFYog-rA6wYJSuurEabVbhzTf_LgGa0HP7hI8pFQHW09q42F2uo6QgldeQ6E22RkwtQ06p1LzOEeVQvamTjluIO6LFOs5gpon8PPik2eIzkNt3RCDM-lx9cCqMcGTYz2rvrx7-3n9oTm_eP9x_fq80T1FvCErCxhrYpkxK9YxRji3HA1KMCY0o8Ct6vkgejJYQwzqMRjTI2o6zQzigp5Vrw6-uzxMYHRZJ6pR7qKbVNzLoJz8U_Huq9yES0lo15U7FYPnR4MYvmVIs5xc0jCOykPISXJEBSME_xMsJ-8J7lYFfPYXuA05-nIFSUjPMBF8gcQB0jGkFMHerYyRXMKXW7lkLJeM5RK-vA1fXpXRp79_-dfgMe0CvDwA390I-_82lm8-XSwd_QnrqcKO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>225612879</pqid></control><display><type>article</type><title>Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Zowall, H ; Cairns, JA ; Brewer, C ; Lamping, DL ; Gedroyc, WMW ; Regan, L</creator><creatorcontrib>Zowall, H ; Cairns, JA ; Brewer, C ; Lamping, DL ; Gedroyc, WMW ; Regan, L</creatorcontrib><description>Objective To estimate the cost‐effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance‐guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy.
Design Cost‐utility analysis based on a Markov model.
Setting National Health Service (NHS) Trusts in England and Wales.
Population Women for whom surgical treatment for uterine fibroids is being considered.
Methods The parameters of the Markov model of the treatment of uterine fibroids are drawn from a series of clinical studies of MRgFUS, and from the clinical effectiveness literature. Health‐related quality of life is measured using the 6D. Costs are estimated from the perspective of the NHS. The impact of uncertainty is examined using deterministic and probabilistic sensitivity analysis.
Main outcome measures Incremental cost‐effectiveness measured by cost per quality‐adjusted life‐year (QALY) gained.
Results The base‐case results imply a cost saving and a small QALY gain per woman as a result of an MRgFUS treatment strategy. The cost per QALY gained is sensitive to cost of MRgFUS relative to other treatments, the age of the woman and the nonperfused volume relative to the total fibroids volume.
Conclusions A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost‐effective.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/j.1471-0528.2007.01657.x</identifier><identifier>PMID: 18333948</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Cost analysis ; Cost-Benefit Analysis ; Cost‐utility analysis ; Embolization, Therapeutic - economics ; Embolization, Therapeutic - methods ; Female ; Fibroids ; focused ultrasound surgery ; Gynaecological Surgery ; Gynecology ; Health economics ; Humans ; Hysterectomy - economics ; Hysterectomy - methods ; Leiomyoma - economics ; Leiomyoma - therapy ; Magnetic Resonance Imaging, Interventional - economics ; Markov Chains ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Quality-Adjusted Life Years ; Surgical techniques ; Ultrasonic imaging ; Ultrasonic Therapy - economics ; uterine fibroids ; Uterine Neoplasms - economics ; Uterine Neoplasms - therapy</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2008-04, Vol.115 (5), p.653-662</ispartof><rights>2008 The Authors</rights><rights>Journal compilation © RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology</rights><rights>2008 The Authors Journal compilation © RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5307-29fe11c2f6dd96466277f70ba8668c63e7fa57b852bfd2d051edd503d4c6d0783</citedby><cites>FETCH-LOGICAL-c5307-29fe11c2f6dd96466277f70ba8668c63e7fa57b852bfd2d051edd503d4c6d0783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1471-0528.2007.01657.x$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1471-0528.2007.01657.x$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18333948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zowall, H</creatorcontrib><creatorcontrib>Cairns, JA</creatorcontrib><creatorcontrib>Brewer, C</creatorcontrib><creatorcontrib>Lamping, DL</creatorcontrib><creatorcontrib>Gedroyc, WMW</creatorcontrib><creatorcontrib>Regan, L</creatorcontrib><title>Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective To estimate the cost‐effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance‐guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy.
Design Cost‐utility analysis based on a Markov model.
Setting National Health Service (NHS) Trusts in England and Wales.
Population Women for whom surgical treatment for uterine fibroids is being considered.
Methods The parameters of the Markov model of the treatment of uterine fibroids are drawn from a series of clinical studies of MRgFUS, and from the clinical effectiveness literature. Health‐related quality of life is measured using the 6D. Costs are estimated from the perspective of the NHS. The impact of uncertainty is examined using deterministic and probabilistic sensitivity analysis.
Main outcome measures Incremental cost‐effectiveness measured by cost per quality‐adjusted life‐year (QALY) gained.
Results The base‐case results imply a cost saving and a small QALY gain per woman as a result of an MRgFUS treatment strategy. The cost per QALY gained is sensitive to cost of MRgFUS relative to other treatments, the age of the woman and the nonperfused volume relative to the total fibroids volume.
Conclusions A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost‐effective.</description><subject>Adult</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Cost‐utility analysis</subject><subject>Embolization, Therapeutic - economics</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Fibroids</subject><subject>focused ultrasound surgery</subject><subject>Gynaecological Surgery</subject><subject>Gynecology</subject><subject>Health economics</subject><subject>Humans</subject><subject>Hysterectomy - economics</subject><subject>Hysterectomy - methods</subject><subject>Leiomyoma - economics</subject><subject>Leiomyoma - therapy</subject><subject>Magnetic Resonance Imaging, Interventional - economics</subject><subject>Markov Chains</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Quality-Adjusted Life Years</subject><subject>Surgical techniques</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic Therapy - economics</subject><subject>uterine fibroids</subject><subject>Uterine Neoplasms - economics</subject><subject>Uterine Neoplasms - therapy</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNqNkctu1DAUhiMEoqXwCihiwS7Bl8T2LECCEVdV6gbWlmMfDx4l9mDHpbPjEfqMfRKczqhcNuDNOdL_nV_H56-qGqMWl_di2-KO4wb1RLQEId4izHreXt2rTu-E-7c9ahAl4qR6lNIWFYog-rA6wYJSuurEabVbhzTf_LgGa0HP7hI8pFQHW09q42F2uo6QgldeQ6E22RkwtQ06p1LzOEeVQvamTjluIO6LFOs5gpon8PPik2eIzkNt3RCDM-lx9cCqMcGTYz2rvrx7-3n9oTm_eP9x_fq80T1FvCErCxhrYpkxK9YxRji3HA1KMCY0o8Ct6vkgejJYQwzqMRjTI2o6zQzigp5Vrw6-uzxMYHRZJ6pR7qKbVNzLoJz8U_Huq9yES0lo15U7FYPnR4MYvmVIs5xc0jCOykPISXJEBSME_xMsJ-8J7lYFfPYXuA05-nIFSUjPMBF8gcQB0jGkFMHerYyRXMKXW7lkLJeM5RK-vA1fXpXRp79_-dfgMe0CvDwA390I-_82lm8-XSwd_QnrqcKO</recordid><startdate>200804</startdate><enddate>200804</enddate><creator>Zowall, H</creator><creator>Cairns, JA</creator><creator>Brewer, C</creator><creator>Lamping, DL</creator><creator>Gedroyc, WMW</creator><creator>Regan, L</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200804</creationdate><title>Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids</title><author>Zowall, H ; Cairns, JA ; Brewer, C ; Lamping, DL ; Gedroyc, WMW ; Regan, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5307-29fe11c2f6dd96466277f70ba8668c63e7fa57b852bfd2d051edd503d4c6d0783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>Cost‐utility analysis</topic><topic>Embolization, Therapeutic - economics</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Fibroids</topic><topic>focused ultrasound surgery</topic><topic>Gynaecological Surgery</topic><topic>Gynecology</topic><topic>Health economics</topic><topic>Humans</topic><topic>Hysterectomy - economics</topic><topic>Hysterectomy - methods</topic><topic>Leiomyoma - economics</topic><topic>Leiomyoma - therapy</topic><topic>Magnetic Resonance Imaging, Interventional - economics</topic><topic>Markov Chains</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Quality-Adjusted Life Years</topic><topic>Surgical techniques</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonic Therapy - economics</topic><topic>uterine fibroids</topic><topic>Uterine Neoplasms - economics</topic><topic>Uterine Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zowall, H</creatorcontrib><creatorcontrib>Cairns, JA</creatorcontrib><creatorcontrib>Brewer, C</creatorcontrib><creatorcontrib>Lamping, DL</creatorcontrib><creatorcontrib>Gedroyc, WMW</creatorcontrib><creatorcontrib>Regan, L</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zowall, H</au><au>Cairns, JA</au><au>Brewer, C</au><au>Lamping, DL</au><au>Gedroyc, WMW</au><au>Regan, L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2008-04</date><risdate>2008</risdate><volume>115</volume><issue>5</issue><spage>653</spage><epage>662</epage><pages>653-662</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objective To estimate the cost‐effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance‐guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy.
Design Cost‐utility analysis based on a Markov model.
Setting National Health Service (NHS) Trusts in England and Wales.
Population Women for whom surgical treatment for uterine fibroids is being considered.
Methods The parameters of the Markov model of the treatment of uterine fibroids are drawn from a series of clinical studies of MRgFUS, and from the clinical effectiveness literature. Health‐related quality of life is measured using the 6D. Costs are estimated from the perspective of the NHS. The impact of uncertainty is examined using deterministic and probabilistic sensitivity analysis.
Main outcome measures Incremental cost‐effectiveness measured by cost per quality‐adjusted life‐year (QALY) gained.
Results The base‐case results imply a cost saving and a small QALY gain per woman as a result of an MRgFUS treatment strategy. The cost per QALY gained is sensitive to cost of MRgFUS relative to other treatments, the age of the woman and the nonperfused volume relative to the total fibroids volume.
Conclusions A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost‐effective.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18333948</pmid><doi>10.1111/j.1471-0528.2007.01657.x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2008-04, Vol.115 (5), p.653-662 |
| issn | 1470-0328 1471-0528 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Cost analysis Cost-Benefit Analysis Cost‐utility analysis Embolization, Therapeutic - economics Embolization, Therapeutic - methods Female Fibroids focused ultrasound surgery Gynaecological Surgery Gynecology Health economics Humans Hysterectomy - economics Hysterectomy - methods Leiomyoma - economics Leiomyoma - therapy Magnetic Resonance Imaging, Interventional - economics Markov Chains Middle Aged NMR Nuclear magnetic resonance Quality-Adjusted Life Years Surgical techniques Ultrasonic imaging Ultrasonic Therapy - economics uterine fibroids Uterine Neoplasms - economics Uterine Neoplasms - therapy |
| title | Cost‐effectiveness of magnetic resonance‐guided focused ultrasound surgery for treatment of uterine fibroids |
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