A comparison of the cost–utility of ultrasound‐guided high‐intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study

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.