Rana, D;
Wu, O;
Cheed, V;
Middleton, LJ;
Moss, J;
Lumsden, M-A;
McKinnon, W;
Daniels, J;
Sirkeci, F;
Manyonda, I;
et al.
Rana, D; Wu, O; Cheed, V; Middleton, LJ; Moss, J; Lumsden, M-A; McKinnon, W; Daniels, J; Sirkeci, F; Manyonda, I; Belli, A-M; McPherson, K; FEMME Trial Collaborative Group
(2021)
Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost-utility analysis of the FEMME trial.
BJOG, 128 (11).
pp. 1793-1802.
ISSN 1471-0528
https://doi.org/10.1111/1471-0528.16781
SGUL Authors: Manyonda, Isaac Tainzana
Abstract
OBJECTIVES: To assess the cost-effectiveness of uterine artery embolisation (UAE) and myomectomy for women with symptomatic uterine fibroids wishing to avoid hysterectomy. DESIGN: Economic evaluation alongside the FEMME randomised controlled trial. SETTING: 29 UK hospitals. POPULATION: 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). METHODS: A within-trial cost-utility analysis was conducted from the perspective of the UK NHS. MAIN OUTCOME MEASURES: 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. RESULTS: 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). CONCLUSIONS: 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.
Item Type: |
Article
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Additional Information: |
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: |
Cost-effectiveness, economic evaluation, myomectomy, uterine artery embolisation, uterine fibroids, FEMME Trial Collaborative Group, Cost-effectiveness, economic evaluation, myomectomy, uterine artery embolisation, uterine fibroids, 11 Medical and Health Sciences, Obstetrics & Reproductive Medicine |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
BJOG |
ISSN: |
1471-0528 |
Language: |
eng |
Dates: |
Date | Event |
---|
21 September 2021 | Published | 5 July 2021 | Published Online | 19 April 2021 | Accepted |
|
Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
|
PubMed ID: |
34053154 |
Web of Science ID: |
WOS:000669553600001 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/113524 |
Publisher's version: |
https://doi.org/10.1111/1471-0528.16781 |
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