The economic impact of uterine fibroids in the United States: A summary of published estimates
The economic impact of uterine fibroids in the United States: A summary of published estimates
复制标题
DOI：
10.1089/jwh.2005.14.692
复制
发表时间：
2005-10-01
影响因子：
3.5
通讯作者：
Duchane, J
中科院分区：
文献类型：
--
作者：
Mauskopf, J;Flynn, M;Duchane, J
目的：对美国子宫肌瘤的经济负担发表一份总结，并确定进一步研究的领域。方法：检索三个电子数据库，MEDLINE，EMBASE和Current Contents，沿着回顾互联网上的信息和经济数据的摘要。结果：只有10篇论文和1篇互联网文献符合我们的纳入标准，并用于提取数据。子宫肌瘤手术侵入性治疗的成本估计包括子宫切除术（5，012 - 7，934美元），肌瘤切除术（5，425 - 11，839美元）和子宫动脉栓塞术（UAE）（5，425 - 7，645美元）（2004年美元）。一项成本效益研究估计，与子宫切除术相比，UAE的成本更低，质量调整生命年更高。第二项研究估计，如果使用促性腺激素释放激素（GnRH）激动剂预处理后阴道（与腹部）子宫切除术的发生率高于未使用GnRH激动剂预处理的患者，则美国可能节省420万美元的住院费用（80% vs. 13%）。没有估计子宫肌瘤的直接和间接经济负担。既没有估计的费用为门诊护理的肌瘤，也没有研究估计的间接费用与管理的肌瘤和他们的症状被发现。S.经济估计表明，尽管子宫肌瘤的患病率很高，而且对临床实践和妇女生活产生影响，但除了数据显示子宫肌瘤的标准治疗具有侵入性且昂贵之外，有关其经济影响的公开信息很少。通过增加非侵入性治疗的使用来减少侵入性手术的需求和成本，可能会显著节省国家成本，但需要进一步的临床和经济研究。
Objective: To present a summary of published estimates of the economic burden of uterine fibroids in the United States and identify areas for additional research.Methods: A search of three electronic databases, MEDLINE, EMBASE, and Current Contents, was conducted, along with a review of information on the Internet and abstraction of economic data.Results: Only 10 papers and 1 Internet document met our inclusion criteria and were used to abstract data. Cost estimates for surgically invasive treatments of uterine fibroids included hysterectomy ($5,012-$7,934), myomectomy ($5,425-$11,839), and uterine artery embolization (UAE) ($5,425-$7,645) (2004$). One cost-effectiveness study estimated lower costs and higher quality-adjusted life years with UAE compared with hysterectomy. A second study estimated potential savings of $4.2 million in hospital charges in the United States if higher rates of vaginal (vs. abdominal) hysterectomy would be achieved after pretreatment with gonadotropin hormone-releasing hormone (GnRH) agonists compared to without pretreatment with GnRH agonists (80% vs. 13%). There were no estimates of the total direct and indirect economic burden of uterine fibroids. Neither estimates of the costs for the ambulatory care of fibroids nor studies estimating the indirect costs associated with the management of fibroids and their symptoms were found.Conclusions: This summary of published U. S. economic estimates shows that despite the high prevalence of fibroids and their impact on clinical practice and women's lives, there is very little published information on their economic impact apart from data showing standard treatments for uterine fibroids are invasive and expensive. Reduction in the need for and cost of invasive procedures by the increased usage of noninvasive treatments could potentially achieve significant national cost savings, but further clinical and economic studies are needed.