Abstract
BackgroundTo 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.MethodsThis 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.ResultsThe 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.ConclusionsAdjusted all-cause and UF-related costs at one year were not significantly different between patients undergoing MRgFUS, myomectomy and UAE.
Highlights
Uterine fibroids (UF) are benign clonal tumors affecting more than one-fifth of all women of reproductive age in the U.S [1,2]
Since magnetic resonance-guided focused ultrasound (MRgFUS) was approved by FDA in 2004 and uterine artery embolization (UAE) and myomectomy were approved much earlier than that, we considered all patients who had a uterine fibroid (UF) procedure between 2004 and 2009
Given that only 14 of the 48 MRgFUS patients found in the MarketScan database met all our criteria for length of enrollment, we provided a flowchart in Figure 2 to document the attrition of patients due to each inclusion/exclusion criterion
Summary
Uterine fibroids (UF) are benign clonal tumors affecting more than one-fifth of all women of reproductive age in the U.S [1,2]. UF-related morbidity has significant economic implications with direct costs ranging from $5,395 to $9,610 (in adjusted 2010 U.S Dollars) [1,6,7]. Among the available alternatives to hysterectomy for UF are endoscopic and abdominal myomectomy, uterine artery embolization (UAE) and magnetic resonance-guided focused ultrasound (MRgFUS). This study aims to compare both (i) all-cause direct healthcare costs and (ii) UF-related direct healthcare costs between MRgFUS, UAE and myomectomy cohorts one year following treatment. This study will use reimbursed amounts by commercial payers as healthcare costs, and provide real-world evidence of relative costs between the three uterine-sparing procedures for UF treatment. 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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
