A Cost-Utility Analysis of Abdominal Hysterectomy Versus Transcervical Endometrial Resection for the Surgical Treatment of Menorrhagia

Published online by Cambridge University Press: 10 March 2009 Menorrhagia, or heavy regular menstrual bleeding, represents a major health burden to women. Trials comparing abdominal hysterectomy (AH) with transcervical resection of the endometrium (TCRE) for the condition have shown that, although the duration and severity of convalescence is less with TCRE, AH produces a permanent solution to heavy bleeding while TCRE fails in a proportion of women by 2 years. However, by 2 years, TCRE costs only 71% that of AH. This paper presents a cost-utility analysis to assess which procedure is more cost-effective overall. Under most plausible parameter values and on the basis of health state values elicited from a sample of women with menorrhagia, AH is likely to be considered more cost-effective than TCRE if purchasers are willing to pay an additional cost of at least £6,500 per extra quality-adjusted life-year generated by AH. - Type - General Essays - Information - International Journal of Technology Assessment in Health Care , Volume 14 , Issue 2 , Spring 1998 , pp. 302 - 319 - Copyright - Copyright © Cambridge University Press 1998 1.Bradlow, J., Coulter, A., & Brooks, P.Patterns of referral, Oxford. Oxford: Health Services Research Unit, 1992.Google Scholar 2.Bridgman, S. A.Increasing operative rates for dysfunctional uterine bleeding after endometrial ablation [letter]. Lancet, 1994, 344, 893.CrossRefGoogle ScholarPubMed 3.Briggs, A., Sculpher, M. J., & Buxton, M.Uncertainty in the economic evaluation of health care technologies: The role of sensitivity analysis. 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