Medico-economic approach to the management of uterine myomas: a 6-month cost-effectiveness study of pelvic embolization versus vaginal hysterectomy.
BACKGROUND
Uterine artery embolization is a technique that has been recently proposed for the management of uterine myomas an alternative to vaginal hysterectomy. The results provided by the first published studies demonstrate a significant decrease in symptoms in 70-95% of cases. The aim of our study was to compare the cost-effectiveness ratios for pelvic embolization and vaginal hysterectomy looked at from the hospital point of view.


METHODS
Two populations of patients were randomly selected from women undergoing pelvic embolization or vaginal hysterectomy. We retrospectively measured the cost at 6 months of the two types of procedure (costs of hospitalization, drugs, and complementary examinations) as well as the success of each of them at 6 months. The cost of the techniques themselves were measured prospectively on the basis of four procedures.


RESULTS
The cost-effectiveness ratios were 2320 Euros per success (mean cost 2134 Euros per effectiveness 92%) for embolization and 2789 Euros per success (mean cost 2789 Euros per effectiveness 100%) for hysterectomy.


CONCLUSIONS
Pelvic embolization is more cost-effective than vaginal hysterectomy. The integration of the notion of quality of life with the notion of cost should permit a future study to reinforce interest in performing pelvic embolizations in the management of uterine myomas.
Pourrat
Xavier J L
XJ
Pharmacy Department, University Hospital, 2 Boulevard Tonnellé, 37 044 Tours Cedex, France. x.pourrat@chu-tours.fr
Fourquet
Florence
F
Guerif
Fabrice
F
Viratelle
Nelly
N
Herbreteau
Denis
D
Marret
Henry
H
D003362:Cost-Benefit Analysis; D004621:Embolization, Therapeutic / Q000191:economics*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000191:economics*; D008875:Middle Aged; D009214:Myoma / Q000601:surgery / Q000628:therapy*; D010388:Pelvis; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000601:surgery / Q000628:therapy*