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« on: July 28, 2009, 03:19:59 pm » |
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Author: Christina Lau
Source: Medical Tribune
The levonorgestrel intrauterine system (LNG-IUS) is more cost-effective than hysterectomy for the treatment of heavy menstrual bleeding, a 10-year study reveals.
The study of more than 200 women with heavy menstrual bleeding (aged 34 to 49 years) in Finland showed that treatment with the LNG-IUS is associated with a cost saving of up to 37 percent in terms of work productivity loss and healthcare costs, compared with hysterectomy.
“The VUOKKO* study is the first ever study to compare the cost-effectiveness of the LNG-IUS with hysterectomy in the treatment of heavy menstrual bleeding,” said Dr. Ritva Hurskainen, who is lead investigator of the study and head of obstetrics and gynecology at the Hyvinkää Hospital in Finland. “The 5-year results were published in [The Journal of the American Medical Association] in 2004.”
The latest follow-up data that are to be published showed that over a period of 10 years, work productivity loss due to sick leave in women treated with the LNG-IUS was US$1,030, while that in women treated with hysterectomy was US$1,900. Healthcare cost in 10 years was US$2,000 for women treated with an LNG-IUS, compared with US$2,900 for women who had a hysterectomy, according to Hurskainen.
“The additional healthcare cost in the hysterectomy group was due to preoperative visits, hospital stays, complications, re-admission to hospital, etc.,” explained Hurskainen.
In addition, women treated with the LNG-IUS had lower rates of urinary tract infections (14 versus 33.5 percent), bladder emptying problems (3 versus 13 percent), urge incontinence (7 versus 19 percent), stress incontinence (5 versus 26 percent), ovarian cysts (3 versus 9 percent) and estrogen use (3 versus 9 percent) than those who had hysterectomies, in the study. Health-related quality of life in 10 years was also significantly better in women treated with the LNG-IUS.
The LNG-IUS is a recommended first-line treatment for heavy menstrual bleeding in countries such as the UK, Finland and China. “About one-third of women at reproductive age experience heavy menstrual bleeding at some point in their life,” said Hurskainen. “With its significant impact on health, work and social life, women with heavy menstrual bleeding should be treated.”
How common is heavy menstrual bleeding in Asia?
• In Singapore: Approximately 5 to 10 percent of women
• In Hong Kong: Third most common cause of gynecological hospital admission, and second most common benign gynecological condition for hysterectomy in public hospitals
* VUOKKO = Vuodot (menorrhagia) Kierukka (IUS) Kohdunpoisto (hysterectomy)
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