Rana, D. et al. (2021) Uterine artery embolization or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost-utility analysis of the FEMME trial. BJOG: An International Journal of Obstetrics and Gynaecology, 128(11), pp. 1793-1802. (doi: 10.1111/1471-0528.16781) (PMID:34053154)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
243105.pdf - Published Version Available under License Creative Commons Attribution. 694kB |
Abstract
Objectives: To assess the cost-effectiveness of uterine artery embolization (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 measured using the EuroQoL 3L, combined with costs to estimate cost-effectiveness over two and four years of follow-up. Results: Over a two-year time horizon, UAE was associated with higher mean costs (difference £645; 95% CI -1,381 to 2,580) and lower QALYs (difference -0.09; 95% CI -0.11 to -0.04) when compared with myomectomy. Similar results were observed over the four-year time horizon. Thus, UAE was dominated by myomectomy. Results of the sensitivity analyses were consistent with the basecase results for both years. Over two years, UAE was associated with higher costs (difference £456; 95% CI -1,823; 3,164) and lower QALYs (difference -0.06; 95% CI (-0.11; -0.02). Conclusions: Myomectomy is a cost-effective option for the treatment of uterine fibroids. The differences in costs and quality-adjusted life years are small. Women should be fully informed and have the option to choose between the two procedures.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding: National Institute of Health Research (NIHR) Health Technology Assessment programme reference number 08/53/22. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Moss, Professor Jonathan and Rana, Miss Dikshyanta and Wu, Professor Olivia |
| Authors: | Rana, D., Wu, O., Cheed, V., Middleton, L. J., Moss, J., Lumsden, M. A., McKinnon, W., Daniels, J., Sirkeci, F., Manyonda, I., Belli, A.-M., and McPherson, K. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
| Journal Name: | BJOG: An International Journal of Obstetrics and Gynaecology |
| Publisher: | Wiley |
| ISSN: | 1470-0328 |
| ISSN (Online): | 1471-0528 |
| Published Online: | 30 May 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published in BJOG: An International Journal of Obstetrics and Gynaecology 128(11): 1793-1802 |
| Publisher Policy: | Reproduced under a Creative Commons License |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information