TY - JOUR
T1 - The cost-effectiveness of oral contraceptives compared to ‘no hormonal treatment’ for endometriosis-related pain: An economic evaluation
AU - Grand, Tobias Sydendal
AU - Basarir, Hasan
AU - Jackson, Louise
PY - 2019/1/30
Y1 - 2019/1/30
N2 - Objective To develop a preliminary cost-effectiveness model that compares oral contraceptives and ‘no hormonal treatment’ for the treatment of endometriosis-related pain. Methods A de novo preliminary state transition (Markov) model was developed. The model was informed by systematic literature review and expert opinion. The uncertainty around the results was assessed both by deterministic and probabilistic sensitivity analyses. The economic evaluation was conducted from National Health Service (NHS) England perspective. The main outcome measure was incremental cost per quality-adjusted life year (QALY), with cost-effectiveness plane and cost-effectiveness acceptability curves presented for alternative willingness-to-pay thresholds. Results Oral contraceptives dominated ‘no hormonal treatment’ and provided more QALYs at a lower cost than ‘no hormonal treatment’, with a cost-effectiveness probability of 98%. A one-way sensitivity analysis excluding general practitioner consultations showed that oral contraceptives were still cost-effective. Conclusions The analyses showed that oral contraceptives could be an effective option for the treatment of endometriosis, as this treatment was shown to provide a higher level of QALYs at a lower cost, compared to ‘no hormonal treatment’. The results are subject to considerable parameter uncertainty as a range of assumptions were required as part of the modelling process.
AB - Objective To develop a preliminary cost-effectiveness model that compares oral contraceptives and ‘no hormonal treatment’ for the treatment of endometriosis-related pain. Methods A de novo preliminary state transition (Markov) model was developed. The model was informed by systematic literature review and expert opinion. The uncertainty around the results was assessed both by deterministic and probabilistic sensitivity analyses. The economic evaluation was conducted from National Health Service (NHS) England perspective. The main outcome measure was incremental cost per quality-adjusted life year (QALY), with cost-effectiveness plane and cost-effectiveness acceptability curves presented for alternative willingness-to-pay thresholds. Results Oral contraceptives dominated ‘no hormonal treatment’ and provided more QALYs at a lower cost than ‘no hormonal treatment’, with a cost-effectiveness probability of 98%. A one-way sensitivity analysis excluding general practitioner consultations showed that oral contraceptives were still cost-effective. Conclusions The analyses showed that oral contraceptives could be an effective option for the treatment of endometriosis, as this treatment was shown to provide a higher level of QALYs at a lower cost, compared to ‘no hormonal treatment’. The results are subject to considerable parameter uncertainty as a range of assumptions were required as part of the modelling process.
KW - Cost-effectiveness analysis
KW - systematic literature review
KW - endometriosis-related pain
KW - oral contraceptives
KW - Markov modelling
UR - http://www.scopus.com/inward/record.url?scp=85060776662&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0210089
DO - 10.1371/journal.pone.0210089
M3 - Article
C2 - 30699134
SN - 1932-6203
VL - 14
SP - e0210089
JO - PLoS ONE
JF - PLoS ONE
IS - 1
M1 - e0210089
ER -