ABSTRACT
OBJECTIVE: To evaluate the economic and clinical benefits of endometrial radiofrequency ablation (RFA) compared with other ablation techniques for the treatment of menorrhagia. METHODS: Using German health claims data, women meeting defined inclusion criteria for the intervention group (RFA) were selected. A comparable control group (other endometrial ablations) was established using propensity score matching. These two groups were compared during the quarter of treatment (QoT) and a follow-up of 2 years for the following outcomes: costs during QoT and during follow-up, repeated menorrhagia diagnoses during follow-up and necessary retreatments during follow-up. RESULTS: After performing propensity score matching, 50 cases could be allocated to the intervention group, while 38 were identified as control cases. Patients in the RFA group had 5% fewer repeat menorrhagia diagnoses (40% vs 45%; not significant) and 5% fewer treatments associated with recurrent menorrhagia (6% vs 11%; not significant) than cases in the control group. During the QoT, the RFA group incurred 578 additional costs (2,068 vs 1,490; ns). However, during follow-up, the control group incurred 1,254 additional costs (4,561 vs 5,815; ns), with medication, outpatient physician consultations, and hospitals costs being the main cost drivers. However, none of the results were statistically significant. CONCLUSION: Although RFA was more cost-intensive in the QoT compared with other endometrial ablation techniques, an average total savings of 676 was generated during the follow-up period. While having evidence that RFA is clinically equivalent to other endometrial ablation procedures, we generated indications that RFA is non-inferior and favorable with regard to economic outcomes.
ABSTRACT
OBJECTIVE: To assess clinical and economic benefits of radiofrequency ablation (RFA) compared to hysterectomy when treating patients suffering from menorrhagia. METHODS: Based on German health claims data, a retrospective, longitudinal, observational analysis was performed. Patients having continuously statutory health insurance coverage during the study and being coded for menorrhagia and a relevant treatment option were included in the analysis. The control group was created using propensity score matching. RESULTS: We discovered that using RFA generates cost savings of 1844 during the quarter of performance. As direct costs during a 2-year follow-up show similar levels in both groups, these initial savings can be preserved. This is partly because even if more patients in the RFA group were re-coded for menorrhagia after initial therapy, just a small proportion of these patients required another surgical intervention. CONCLUSION: RFA should more often be considered a relevant treatment option both from an economic and a medical point of view.
