The cost-effectiveness of ulipristal acetate tablets in treating patients with moderate to severe symptoms of uterine fibroids

Balázs Nagy, György Timár, Judit Józwiak-Hagymásy, Gábor Kovács, Gergo Merész, István Vámossy, Tamás Ágh, Ádám László, Z. Vokó, Z. Kaló

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: Ulipristal acetate is a selective progesterone receptor modulator that has been demonstrated to be an effective 3-month pre-operative treatment for moderate to severe symptoms of uterine fibroids in adult women of reproductive age. The aim of this analysis was to assess the cost-effectiveness of 5 mg ulipristal as an add-on therapy to standard pre-surgical observation and treatment in Hungary. Study design: A Markov model was developed using a 10-year time horizon. Ulipristal was compared with pre-surgical observation and immediate hysterectomy. The model comprised the following mutually exclusive health states: mild, moderate, severe, or persistent severe excessive bleeding disorder; myomectomy; post-myomectomy with mildly to moderately excessive bleeding disorder; post-myomectomy with severely excessive bleeding disorder; hysterectomy; post-hysterectomy; post-menopause; and death. Transition probabilities and utility values were obtained from clinical trials and the scientific literature. Resource utilisation and unit costs were derived from a consensus panel of clinical experts, National Health Insurance Fund tariffs, and publications. Results: Adding a 3-month course of ulipristal to pre-operative observation was predicted to achieve an additional 0.021 quality-adjusted life years (QALYs) at an estimated incremental cost of €397, which would result in an incremental cost of €19,200/QALY. When 3 months of ulipristal therapy was compared with immediate hysterectomy, the incremental cost-effectiveness ratio was reduced to €3575/QALY. The results were most sensitive to the utility value of the post-hysterectomy health state but responsive to changes in other model parameters. Conclusions: The results of this analysis suggest that adding ulipristal treatment to standard pre-surgical therapy represents a good value for money in Hungary. The inclusion of societal benefits may considerably reduce the cost-effectiveness ratio.

Original languageEnglish
Pages (from-to)75-81
Number of pages7
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume175
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Leiomyoma
Tablets
Uterine Myomectomy
Cost-Benefit Analysis
Hysterectomy
Quality-Adjusted Life Years
Hungary
Observation
Hemorrhage
Costs and Cost Analysis
Therapeutics
Postmenopause
Literature
Health
National Health Programs
Progesterone Receptors
Publications
ulipristal acetate
ulipristal
Clinical Trials

Keywords

  • Cost-effectiveness
  • Cost-utility analysis
  • Economic evaluation
  • Ulipristal acetate

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine
  • Medicine(all)

Cite this

The cost-effectiveness of ulipristal acetate tablets in treating patients with moderate to severe symptoms of uterine fibroids. / Nagy, Balázs; Timár, György; Józwiak-Hagymásy, Judit; Kovács, Gábor; Merész, Gergo; Vámossy, István; Ágh, Tamás; László, Ádám; Vokó, Z.; Kaló, Z.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 175, No. 1, 2014, p. 75-81.

Research output: Contribution to journalArticle

Nagy, Balázs ; Timár, György ; Józwiak-Hagymásy, Judit ; Kovács, Gábor ; Merész, Gergo ; Vámossy, István ; Ágh, Tamás ; László, Ádám ; Vokó, Z. ; Kaló, Z. / The cost-effectiveness of ulipristal acetate tablets in treating patients with moderate to severe symptoms of uterine fibroids. In: European Journal of Obstetrics Gynecology and Reproductive Biology. 2014 ; Vol. 175, No. 1. pp. 75-81.
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