Cost-effectiveness of continuous combined hormone replacement therapy in long-term use: economic evaluation based on a 9-year study in Finland.
OBJECTIVE
To investigate the cost-effectiveness of continuous combined hormone replacement therapy (ccHRT) (Indivina) in postmenopausal women in Finland treated for up to nine consecutive years in the course of a randomised controlled trial.


METHODS
In-study event data were accrued for cardiac and vascular events, cancers and fractures. These event incidence data were applied to first-year direct medical costs for these events, derived from published sources. Reference event incidence data were derived from hospital discharge records and relevant national registries for age-matched women (aged 50-70 years) in Finland with an assumed HRT usage rate of 40%. Cost-effectiveness was expressed as additional cost per quality-adjusted life year (QALY) gained for women on ccHRT compared with the general population. All input data were discounted at 3% per annum.


RESULTS
The additional cost per QALY gained for ccHRT was less than 5000 euro throughout the nine calendar years examined and remained well below the threshold of acceptability of 50,000 euro in a range of sensitivity analyses. The lowest dose-combination of ccHRT examined improved quality of life at no greater cost than no treatment.


CONCLUSIONS
This appraisal, based on event data from a uniquely long study of ccHRT, indicates that this intervention is cost-effective for the relief of symptoms of menopause.
Ylikangas
Stiina
S
Orion Pharma, Sollentuna, Sweden. stiina.ylikangas@orionpharma.com
Bäckström
Torbjörn
T
Heikkinen
Jorma
J
D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D005387:Finland; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017698:Postmenopause; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D012307:Risk Factors