1857 Deep Endometriosis Transvaginal Ultrasound in the Workup of Patients with Signs and Symptoms of Endometriosis: A Cost Analysis

Abstract

Study Objective Deep endometriosis transvaginal ultrasound (DE TVS) is accurate in the detection of ovarian and DE; however, realization of its full potential and utilization remains variable. As such, patients may require a two-step surgical approach (diagnostic followed by therapeutic laparoscopy) or experience incomplete surgical treatment. Besides the clinical implications, the economic impact of a two-step approach to diagnosis and treatment on the healthcare system is likely to be significant. We aim to compare the economic costs of two diagnostic models of care for patients with potential endometriosis. Design A health economics study using a Markov model with a 12-month time horizon. Setting A tertiary gynecology clinic. Patients or Participants A hypothetical population of 1000 patients visiting a public gynecology clinic for potential endometriosis. Interventions Comparison of the conventional model (M1), which includes the basic TVS and diagnostic laparoscopy, and the novel model (M2), which includes the DE TVS. Measurements and Main Results The Markov model was built to estimate the change to government, health service and patient costs with the adoption of the DE TVS compared to standard diagnostic methods. Australian dollars (AUD) are also depicted in the United States and Canadian dollars (USD and CAD). Probabilistic sensitivity analysis was conducted to capture the uncertainty in the information used to populate the models. The total annual cost of novel model (M2) is $12,547,724.03 AUD / $8,989,464.34 USD / $11,982,759.48 CAD, cheaper than the conventional model (M1), which cost $13,472,161.67 AUD / $9,651,751.71 USD / $12,865,574.08 CAD. Conclusion For a population of 1000 women, the integration of the DE TVS may save healthcare costs of $924,437.64 AUD / $662,287.37 USD / $882,814.59 CAD annually.