Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost–utility analysis of the FEMME trial

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@article{a0d619feb8514de989435af0a75f2ec5,
title = "Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost–utility analysis of the FEMME trial",
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.",
keywords = "Cost-effectiveness, economic evaluation, myomectomy, uterine artery embolisation, uterine fibroids",
author = "{FEMME Trial Collaborative Group} and D Rana and O Wu and Versha Cheed and Lee Middleton and J. Moss and Mary-ann Lumsden and William McKinnon and Jane Daniels and Fusun Sirkeci and I Manyonda and A-M Belli and K McPherson",
year = "2021",
month = may,
day = "30",
doi = "10.1111/1471-0528.16781",
language = "English",
journal = "BJOG: An International Journal of Obstetrics & Gynaecology",
issn = "1470-0328",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy

T2 - a cost–utility analysis of the FEMME trial

AU - FEMME Trial Collaborative Group

AU - Rana, D

AU - Wu, O

AU - Cheed, Versha

AU - Middleton, Lee

AU - Moss, J.

AU - Lumsden, Mary-ann

AU - McKinnon, William

AU - Daniels, Jane

AU - Sirkeci, Fusun

AU - Manyonda, I

AU - Belli, A-M

AU - McPherson, K

PY - 2021/5/30

Y1 - 2021/5/30

N2 - 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.

AB - 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.

KW - Cost-effectiveness

KW - economic evaluation

KW - myomectomy

KW - uterine artery embolisation

KW - uterine fibroids

U2 - 10.1111/1471-0528.16781

DO - 10.1111/1471-0528.16781

M3 - Article

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

SN - 1470-0328

ER -