HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Beinfeld, M. T. Articles by Gazelle, G. S. Search for Related Content PubMed PubMed Citation Articles by Beinfeld, M. T. Articles by Gazelle, G. S.

Cost-Effectiveness of Uterine Artery Embolization and Hysterectomy for Uterine Fibroids¹

¹ From the Institute for Technology Assessment, Massachusetts General Hosp, 101 Merrimac St, 10th Floor, Boston, MA 02114 (M.T.B., J.L.B., G.S.G.); Dept of Radiology (M.T.B., J.L.B., G.S.G.) and Vincent Gynecology Service (K.B.I.), Massachusetts General Hosp, Harvard Med School, Boston; Dept of Health Policy and Management, Harvard School of Public Health, Boston, Mass (G.S.G.); Dept of Epidemiology and Biostatistics, Erasmus Univ Med Center, Rotterdam, the Netherlands (J.L.B.); and Dept of Medicine, Newton-Wellesley Hosp, Newton, Mass (K.B.I.). Received Nov 14, 2002; revision requested Jan 20, 2003; final revision received Jun 2; accepted Jun 18. Portions of this work are sponsored by the U.S. Dept of the Army under DAMD 17-99-2-9001. Address correspondence to G.S.G.

PURPOSE: To compare the cost-effectiveness of uterine artery embolization (UAE) with that of hysterectomy for women with symptomatic uterine fibroids.

MATERIALS AND METHODS: The authors developed a decision model to compare the costs and effectiveness of UAE and hysterectomy. In the model, a cohort of women aged 40 years with a diagnosis of uterine fibroids and no desire for future pregnancy was followed up until menopause. The analysis was performed from a societal perspective, including all costs and effects, regardless of who incurs them. Transition probability and quality-of-life estimates were obtained from the literature and a gynecologist, whereas costs (in 1999 U.S. dollars) were estimated by using rates of Medicare reimbursement for hospital costs and physician fees. Sensitivity analyses of key estimates were performed. Results were expressed in costs per quality-adjusted life-year (QALY).

RESULTS: UAE was more effective (8.29 vs 8.18 QALYs) and less expensive ($6,916 vs $7,847) than hysterectomy. Cost-effectiveness results, with the exception of quality-of-life data, were robust to changes in most model assumptions. When the quality-of-life adjustment was eliminated, the two procedures were equally effective.

CONCLUSION: UAE is a cost-effective alternative to hysterectomy across a wide range of assumptions about the costs and effectiveness of the two procedures. However, the study results were sensitive to changes in quality-of-life values.

© RSNA, 2004

Index terms: Arteries, therapeutic embolization, 854.1264, 854.1266, 98.1264, 98.1266 • Cost-effectiveness • Uterine neoplasms, 854.315, 854.318 • Uterine neoplasms, therapy, 854.1264, 854.1266, 98.1264, 98.1266

This article has been cited by other articles:

				G. Tropeano, S. Amoroso, and G. Scambia Non-surgical management of uterine fibroids Hum. Reprod. Update, May 1, 2008; 14(3): 259 - 274. [Abstract] [Full Text] [PDF]

				R. A. Bucek, S. Puchner, and J. Lammer Mid- and Long-Term Quality-of-Life Assessment in Patients Undergoing Uterine Fibroid Embolization. Am. J. Roentgenol., March 1, 2006; 186(3): 877 - 882. [Abstract] [Full Text] [PDF]