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Economic Evaluation of Norethisterone Acetate/Ethinylestradiol (FemHRT??) for Women with Menopausal Symptoms
- Source :
- Scopus-Elsevier
- Publication Year :
- 2003
- Publisher :
- Springer Science and Business Media LLC, 2003.
-
Abstract
- Introduction: The objective of this study was to assess the cost effectiveness of a continuous combined oral preparation of norethisterone (norethindrone) acetate and ethinylestradiol (NA/EE) [FemHRT®] as both a first-line and second-line therapy for menopausal women. Perspective: Third-party payer. Methods: The cost effectiveness of NA/EE was assessed as both a first- and second-line therapy in comparison with conjugated equine oestrogen 0.625mg and medroxyprogesterone acetate 2.5mg (CEE/MPA) and no therapy. Analysis was conducted within a Markov model with states relating to the presence and absence of vaginal bleeding, menopausal symptoms and hip fracture. Analysis forecasted life expectancy, QALYs and lifetime costs for a 50-year-old menopausal woman. Compliance was modelled related to menopausal symptoms and vaginal bleeding. For the base-case analysis, it was assumed that compliant women would take therapy for up to 5 years. Sensitivity analysis assumed therapy was taken only for 1 year. Results: Compared with both CEE/MPA and no therapy, NA/EE led to an increase in both costs and QALYs, both as a first- and second-line therapy. For first-line therapy, the incremental cost per QALY gained for NA/EE was $2200 Canadian dollars ($Can; 1999 values) [compared with no therapy] and was $Can20 300 (compared with CEE/MPA). For second-line therapy, the incremental cost per QALY gained for NA/EE was $Can900 (compared with no therapy) and was $Can16 400 (compared with CEE/MPA). Results were robust to most sensitivity analyses. Conclusions: NA/EE is a cost-effective therapy for women with menopausal symptoms both as a first-line and second-line therapy.
- Subjects :
- medicine.medical_specialty
Norethisterone
Cost effectiveness
Cost-Benefit Analysis
medicine.medical_treatment
Ethinyl Estradiol
Decision Support Techniques
Estradiol Congeners
medicine
Humans
Menopausal Symptom
Medroxyprogesterone acetate
Economics, Pharmaceutical
Pharmacology
Gynecology
business.industry
Obstetrics
Health Policy
Public Health, Environmental and Occupational Health
Menopausal Syndrome
Hormone replacement therapy (menopause)
Middle Aged
medicine.disease
Norethisterone acetate
Menopause
Female
Quality-Adjusted Life Years
Norethindrone
business
medicine.drug
Subjects
Details
- ISSN :
- 11707690
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- PharmacoEconomics
- Accession number :
- edsair.doi.dedup.....7ddc2e546a46fc38fff50f7415e48086