The Inspire Comparative Cost Study: One-Year Medical Resource Utilization, and Payer Cost Analysis Associated with Hysterectomy and Myomectomy Compared to Sonography-Guided Transcervical Ablation for the Treatment Of Uterine Fibroids

Abstract

Study Objective The INSPIRE study compared health care resource utilization (HCRU) and payor costs associated with transcervical radiofrequency (RF) ablation, hysterectomy, and myomectomy. Design Data for transcervical RF ablation were derived from a prospective, multicenter, single-arm clinical trial (the SONATA trial); data for hysterectomy and myomectomy arms were derived from the Truven Health MarketScan Commercial Claims Database. Setting 6 clinical sites in the US. Patients or Participants Premenopausal women between the ages of 25 and 50 with heavy menstrual bleeding secondary to fibroids treated prospectively with transcervical RF ablation; matched hysterectomy and myomectomy procedures of interest for uterine fibroids were identified using appropriate diagnostic and procedural codes. Interventions Ultrasound-guided transcervical, intrauterine radiofrequency ablation using the Sonata system® performed on up to 10 fibroids per subject; hysterectomy and myomectomy (for the comparative payor data arms). Measurements and Main Results Mean total payor cost for treatment with the Sonata system and 12-month associated postoperative HCRU ($8,941) were significantly lower than that for hysterectomy ($24,156) or myomectomy ($22,784). Furthermore, the mean payor cost for the 12-month postoperative HCRU associated with Sonata ($143) was significantly lower than that associated with hysterectomy ($699) or myomectomy ($1,444). Finally, Sonata patients had significantly lower costs associated with complications, prescription medication, and radiology studies than either hysterectomy or myomectomy patients. Conclusion Transcervical RF ablation using the Sonata system is a lower-cost alternative to hysterectomy and myomectomy for the treatment of symptomatic uterine fibroids.