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A comparison of the cost–utility of ultrasound‐guided high‐intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study
Author(s) -
Liu XF,
Huang LH,
Zhang C,
Huang GH,
Yan LM,
He J
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14746
Subject(s) - adenomyosis , medicine , hysterectomy , high intensity focused ultrasound , quality of life (healthcare) , retrospective cohort study , cost effectiveness , radiology , surgery , ultrasound , gynecology , endometriosis , risk analysis (engineering) , nursing
Objective To evaluate cost‐effectiveness of ultrasound‐guided high‐intensity focused ultrasound ( US g HIFU ) and open hysterectomy for adenomyosis. Design A retrospective analysis. Setting Gynaecological department in a single centre in China. Population Patients with symptomatic adenomyosis. Main outcome measures Cost difference between patients with adenomyosis treated with US g HIFU and open hysterectomy. Methods Three hundred and sixty‐eight patients with adenomyosis were retrospectively reviewed. Among them, 302 patients were treated with US g HIFU and 66 patients with open hysterectomy. All of them had 1‐, 3‐, 6‐ and 12‐month follow ups. The patients’ quality of life ( QOL ) was evaluated and the utility scores were obtained from a rating scale to conduct a cost–utility analysis ( CUA ). Results No significant differences were found at any follow‐up time point in the QOL between the two groups ( P > 0.05). After treatment, the QOL scores significantly increased in both groups ( P < 0.05): the quality adjusted life year ( QALY ) for patients treated with US g HIFU was USUS $5256.48, whereas it was USUS $7510.03 for patients treated with open hysterectomy. Both incremental cost and sensitivity analysis showed that US g HIFU was less costly than open hysterectomy. Conclusions The QOL of patients with adenomyosis can be significantly improved by either US g HIFU or open hysterectomy, but US g HIFU is less costly. Tweetable abstract US g HIFU can safely be used to treat patients with adenomyosis and significantly improved the quality of life of patients after treatment. The cost of US g HIFU is less than that of surgical treatment.