HUMAN ISSUES AND MEDICAL ECONOMICS OF ENDOMETRIOSIS - 3-MONTH VS. 6-MONTH GNRH-AGONIST THERAPY

OBJECTIVE: To project the efficacy and economic consequences of short- term intranasal gonadotropin-releasing hormone agonist (GnRH-a) for di agnosis of and therapy for endometriosis. STUDY DESIGN: Multi-centre, placebo-controlled clinical trials of GnRH-a comparing three vs. six m onths of treatment, three months of retreatment and three months of po stperative treatment for the symptoms and signs of laparoscopically di agnosed endometriosis. RESULTS: The reduction in symptoms and signs of endometriosis was similar at the end of three months to the relief at six months. Retreatment was as effective as initial treatment, and th e return of symptoms after laparoscopic surgery plus postperative trea tment for three months as compared to surgery alone. The projected cha rges for the surgical approaches (laparoscopy or minilaparoscopy) to d iagnosis and therapy were 50-60% greater than those for the medical ap proach. CONCLUSION: GnRH-a administration for three months could be a cost-effective approach to the presumptive diagnosis and treatment of endometriosis among women with chronic pelvic pain.