title: Cost comparison between uterine-sparing fibroid treatments one year following treatment.
abstract: BACKGROUND
  To compare one-year all-cause and uterine fibroid (UF)-related direct costs in patients treated with one of the following three uterine-sparing procedures: magnetic resonance-guided focused ultrasound (MRgFUS), uterine artery embolization (UAE) and myomectomy.
  
  
  METHODS
  This retrospective observational cohort study used healthcare claims for several million individuals with healthcare coverage from employers in the MarketScan Database for the period 2003-2010. UF patients aged 25-54 on their first UF procedure (index) date with 366-day baseline experience, 366-day follow-up period, continuous health plan enrollment during baseline and follow-up, and absence of any baseline UF procedures were included in the final sample. Cost outcomes were measured by allowed charges (sum of insurer-paid and patient-paid amounts). UF-related cost was defined as difference in mean cost between study cohorts and propensity-score-matched control cohorts without UF. Multivariate adjustment of cost outcomes was conducted using generalized linear models.
  
  
  RESULTS
  The study sample comprised 14,426 patients (MRgFUS = 14; UAE = 4,092; myomectomy = 10,320) with a higher percent of older patients in MRgFUS cohort (71% vs. 50% vs. 12% in age-group 45-54, P < 0.001). Adjusted all-cause mean cost was lowest for MRgFUS ($19,763; 95% CI: $10,425-$38,694) followed by myomectomy ($20,407; 95% CI: $19,483-$21,381) and UAE ($25,019; 95% CI: $23,738-$26,376) but without statistical significance. Adjusted UF-related costs were also not significantly different between the three procedures.
  
  
  CONCLUSIONS
  Adjusted all-cause and UF-related costs at one year were not significantly different between patients undergoing MRgFUS, myomectomy and UAE.
authors.affiliation: Division of Health Care Policy and Research & College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Bijan J
authors.initials: BJ
authors.lastname: Borah
authors.affiliation: Truven Health Analytics, 777 E. Eisenhower Parkway, Ann Arbor, MI 48108, USA.
authors.forename: Ginger S
authors.initials: GS
authors.lastname: Carls
authors.affiliation: Truven Health Analytics, 777 E. Eisenhower Parkway, Ann Arbor, MI 48108, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Moore
authors.affiliation: Truven Health Analytics, 777 E. Eisenhower Parkway, Ann Arbor, MI 48108, USA.
authors.forename: Teresa B
authors.initials: TB
authors.lastname: Gibson
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Moriarty
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology and Department of Surgery, Mayo Clinic and Mayo Medical School, Rochester, Minnesota, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stewart
keywords: Healthcare costs; Magnetic resonance-guided focused ultrasound (MRgFUS); Myomectomy; Uterine artery embolization (UAE); Uterine fibroids