title: Repeated-intermittent use of ulipristal acetate for the management of uterine fibroids: an Italian pharmacoeconomic evaluation.
abstract: BACKGROUND
  The aim of this paper was to evaluate an Italian pharmacoeconomic profile of repeated-intermittent (from 4 to 10 cycles) use of ulipristal acetate 5 mg (UPA 5 mg) in comparison with the use of UPA 5 mg before surgery (2 cycles) for the management of symptomatic uterine fibroids.
  
  
  METHODS
  The pharmacoeconomic analysis was performed in two steps: 1) estimating an incremental cost-effectiveness ratio (ICER); 2) assuming a nationwide prediction of future expenditure in the Italian scenario. Effectiveness data were derived from the randomized-controlled trial, whilst quality of life and costs data were retrieved from the published literature.
  
  
  RESULTS
  In comparison with the use of UPA 5 mg before surgery, the values of ICER per patient were the following: 1) €20,600 euros (UPA 5 mg 4 cycles); 2) €26,884 (UPA 5mg 6 cycles); 3) €30,244 (UPA 5 mg 8 cycles); 4) €31,906 (UPA 5 mg 10 cycles). In comparison with the use of UPA 5 mg before surgery plus subsequent surgery, the saving per patient for the National Healthcare System (NHS) by adding repeated-intermittent use of UPA 5 mg were the following: 1) €26 million (UPA 5 mg 4 cycles); 2) €17.6 million (UPA 5mg 6 cycles); 3) €8.9 million (UPA 5 mg 8 cycles); 4) €0.2 million (UPA 5 mg 10 cycles).
  
  
  CONCLUSIONS
  The results showed that repeated-intermittent use of UPA 5 mg for the long-term treatment of uterine fibroids has a favourable pharmacoeconomic profile up to 10 repeated cycles and may be a cost-saving treatment option for the NHS. Although the data are encouraging, more data are needed regarding the benefits and risks of long-term treatment with UPA.
authors.affiliation: Private Practitioner, Florence, Italy - dario.maratea@gmail.com.
authors.forename: Dario
authors.initials: D
authors.lastname: Maratea
mesh_terms: D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D017850:Economics, Pharmaceutical; D005260:Female; D006801:Humans; D007558:Italy; D007889:Leiomyoma / Q000188:drug therapy* / Q000191:economics; D009649:Norpregnadienes / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000191:economics
chemical_list: D009649:Norpregnadienes; C555622:ulipristal acetate