title: Economic and clinical benefits of endometrial radiofrequency ablation compared with other ablation techniques in women with menorrhagia: a retrospective analysis with German health claims data.
abstract: OBJECTIVE
  To evaluate the economic and clinical benefits of endometrial radiofrequency ablation (RFA) compared with other ablation techniques for the treatment of menorrhagia.
  
  
  METHODS
  Using German health claims data, women meeting defined inclusion criteria for the intervention group (RFA) were selected. A comparable control group (other endometrial ablations) was established using propensity score matching. These two groups were compared during the quarter of treatment (QoT) and a follow-up of 2 years for the following outcomes: costs during QoT and during follow-up, repeated menorrhagia diagnoses during follow-up and necessary retreatments during follow-up.
  
  
  RESULTS
  After performing propensity score matching, 50 cases could be allocated to the intervention group, while 38 were identified as control cases. Patients in the RFA group had 5% fewer repeat menorrhagia diagnoses (40% vs 45%; not significant) and 5% fewer treatments associated with recurrent menorrhagia (6% vs 11%; not significant) than cases in the control group. During the QoT, the RFA group incurred €578 additional costs (€2,068 vs €1,490; ns). However, during follow-up, the control group incurred €1,254 additional costs (€4,561 vs €5,815; ns), with medication, outpatient physician consultations, and hospitals costs being the main cost drivers. However, none of the results were statistically significant.
  
  
  CONCLUSIONS
  Although RFA was more cost-intensive in the QoT compared with other endometrial ablation techniques, an average total savings of €676 was generated during the follow-up period. While having evidence that RFA is clinically equivalent to other endometrial ablation procedures, we generated indications that RFA is non-inferior and favorable with regard to economic outcomes.
authors: HGC GesundheitsConsult GmbH, Duesseldorf, Germany.
authors: Christoph
authors: C
authors: Bischoff-Everding
authors: Gynecological Joint Practice, Mainz, Germany.
authors: Ruediger
authors: R
authors: Soeder
authors: Faculty of Health Care, Hochschule Niederrhein - University of Applied Sciences, Krefeld, Germany.
authors: Benno
authors: B
authors: Neukirch
keywords: Germany; costs; endometrial ablation; health claims data; menorrhagia; radiofrequency ablation