Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Cost Effectiveness and Resource Allocation
Published in: Cost Effectiveness and Resource Allocation 1/2018

Open Access 01-12-2018 | Research

Cost-effectiveness of the recommended medical intervention for the treatment of dysmenorrhea and endometriosis in Japan

Authors: Ichiro Arakawa, Mikio Momoeda, Yutaka Osuga, Ikuko Ota, Kaori Koga

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2018

Login to get access

Abstract

Background and objective

This study aims to assess the cost-effectiveness of early physician consultation and guideline-based intervention to prevent endometriosis and/or disease progression using oral contraceptive (OC) and progestin compared to follow-up of self-care for dysmenorrhea in Japan.

Methods

A yearly-transmitted Markov model of five major health states with four sub-medical states was constructed. Transition probabilities among health and medical states were derived from Japanese epidemiological patient surveys and converted to appropriate parameters for inputting into the model. The dysmenorrhea and endometriosis-associated direct costs included inpatient, outpatient visit, surgery, and medication (OC agents, over-the-counter drugs), etc. The utility measure for patients with phase I–IV endometriosis comprised a visual analogue scale. We estimated the cost per quality-adjusted life year (QALY) at a time horizon of 23 years. An annual discount rate at 3% for both cost and outcome was considered.

Results

The base case outcomes indicated that the intervention would be more cost-effective than self-care, as the incremental cost-effectiveness ratio (ICER) yielded 115,000 JPY per QALY gained from the healthcare payers’ perspective and the societal monetary value (SMV) was approximately positive 3,130,000 JPY, favoring the intervention in the cost–benefit estimate. A tornado diagram depicting the stochastic sensitivity analysis of the ICER and SMV from both the healthcare payers’ and societal perspectives confirmed the robustness of the base case. A probabilistic analysis resulting from 10,000-time Monte Carlo simulations demonstrated efficiency at willingness-to-pay thresholds in more than 90% of the iterations.

Conclusions

The present analysis demonstrated that early physician consultation and guideline-based intervention would be more cost-effective than self-care in preventing endometriosis and/or disease progression for patients with dysmenorrhea in Japan.
Literature
1.
2.
Kawama M, Maruyama K, Nakamura K. Prevalence of dysmenorrhea and its correlating lifestyle factors in Japanese female junior high school students. Tohoku J Exp Med. 2015;236:107–13.CrossRef
3.
4.
Tanaka E, Momoeda M, Osuga Y, et al. Burden of menstrual symptoms in Japanese women—an analysis of medical care-seeking behavior from a survey-based study. Int J Women’s Health. 2014;6:11–23.
5.
Proctror M, Farquhar C. Diagnosis and management of Dysmenorrhea. BMJ. 2006;332:1132–8.CrossRef
6.
Tanaka E, Momoeda M, Osuga Y, et al. Burden of menstrual symptoms in Japanese women: results from a survey-based study. J Med Econ. 2013;16(11):1255–66.CrossRefPubMed
7.
8.
Gemmell LC, Webster KE, Kirtley S, et al. The management of menopause in women with a history of endometriosis: a systematic review. Hum Reprod Update. 2017;23(4):481–500.CrossRefPubMedPubMedCentral
9.
10.
11.
12.
Tutunaru D, Vladareanu R, Dumitrascu MC, Alexandru B. Placebo effect of diagnostic laparoscopy alone in mild endometriosis. J Gynaecol Obstet. 2006;2:144.
13.
Duffy JM, Aramnage K, Correa FJ, et al. Laparoscpoic surgery for endometriosis. Cochrane Database Syst Rev. 2014;3:CD011031.
14.
Lee ET, Wang HW. Some well-known parametric survival distributions and their applications. In: Lee ET, Wang HW, editors. Statistical methods for survival data analysis. 3rd ed. New Jersey: John Wiely & Sons, Inc. 2003; p. 134–6.CrossRef
15.
16.
17.
Drummond MF, Sculpher MJ, Claxton K, et al. Choice of discount rate. In: Drummond MF, Sculpher MJ, Claxton K, et al, editors. Methods for the economic evaluation of health care programmes. 4th ed. New York: Oxford University Press; 2015. p. 244.
18.
Shiroiwa T, Sung YK, Fukuda T, et al. International survey on willingness-to-day (WTP) for one additional QALY gained. Health Econ. 2010;19(4):422–37.CrossRefPubMed
19.
Drummond MF, Sculpher MJ, Claxton K, et al. Probabilistic sensitivity analysis. In: Drummond MF, Sculpher MJ, Claxton K, et al, editors. Methods for the economic evaluation of health care programmes. 4th ed. New York: Oxford University Press; 2015. p. 399–401.
20.
Sanghera S, Barton P, Bhattacharya S, Home AW, Roberts TE, PRE-EMPT research group. Pharmaceutical treatments to prevent recurrence of endometriosis following surgery: a model-based economic evaluation. BMJ Open. 2016;6:e10580.CrossRef
21.
Witt CM, Reinhold T, Brinkhaus B, et al. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. 2008;198(2):166.e1–e8.CrossRef
22.
Kim SY, Lee H, Chae Y, et al. A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture. Acupunct Med. 2012;30:273–85.CrossRefPubMed
23.
Schroder AK, Dirdrich K, Ludwing M. Medical management of endometriosis: a systematic review. IDrugs. 2004;7(5):451–63.PubMed
24.
Momoeda M, Mizunuma H, Taketani Y. Treatment of functional and organic dysmenorrhea: efficacy and safety of drospirenone/ethinylestradiol combination tablet. Jpn J Obstet Gynecol (Sanka to Fujinka). 2011;8:977–88 (in Japanese).
25.
Ballard KD, Seaman HE, de Vries CS, Wright JT. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study—Part 1. BJOG. 2008;115:1382–91.CrossRefPubMed
26.
Ballard KD, Lowton K, Wright J. What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis. Fertil Steril. 2006;86:1296–301.CrossRefPubMed
27.
Adachi T. Dysmenorrhea in adolescent girls. Acta Obstet Gynaec Jpn. 2007;59(9):460 (in Japanese).
28.
Tsutsumi O, Terakawa N, Hoshiai H, et al. Research on prevention, diagnosis and treatment strategies of endometriosis from viewpoint of reproductive health (Sexual and reproductive health). Health Sciences Research Grant-in-Aid in 2000; 2000. p. 507–50. (in Japanese).
29.
Gaihoren (Surgeons’ committee on insurance of surgical interventions). Proposed national insurance price list of surgical interventions (2014 version). In: Surgeons’ Group, editor; Igakutsushinsha, Tokyo; 2014. p. 218–9. (in Japanese).
30.
Nagata Y, Nakamura G, Kusuda M. Studies on the classification of endometriosis. Acta Obstet Gynaec Jpn. 1982;34(9):1496–502 (in Japanese).
31.
Drummond MJ, Sculpher MJ, Claxton K, et al. Health gain. In: Methods for the economic evaluation of health care programmes. 4th ed. New York: Oxford University Press; 2015. p. 137–9.
Metadata
Title
Cost-effectiveness of the recommended medical intervention for the treatment of dysmenorrhea and endometriosis in Japan
Authors
Ichiro Arakawa
Mikio Momoeda
Yutaka Osuga
Ikuko Ota
Kaori Koga
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2018
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/s12962-018-0097-8

Other articles of this Issue 1/2018

Cost Effectiveness and Resource Allocation 1/2018 Go to the issue

Research

A pilot study on patient-related costs and factors associated with the cost of specialist palliative care in the hospital: first steps towards a patient classification system in Germany

Review

Value judgment of health interventions from different perspectives: arguments and criteria

Letter to the Editor

Response to: Costs and savings associated with a pharmacists prescribing for minor ailments program in Saskatchewan

Research

Brief interventions to address substance use among patients presenting to emergency departments in resource poor settings: a cost-effectiveness analysis

Research

Cost-effectiveness of umeclidinium compared with tiotropium and glycopyrronium as monotherapy for chronic obstructive pulmonary disease: a UK perspective

Research

Empirical estimation of resource constraints for use in model-based economic evaluation: an example of TB services in South Africa