A COST-UTILITY ANALYSIS OF ABDOMINAL HYSTERECTOMY VERSUS TRANSCERVICAL ENDOMETRIAL RESECTION FOR THE SURGICAL-TREATMENT OF MENORRHAGIA

Menorrhagia, or heavy regular menstrual bleeding, represents a major h ealth burden to women. Trials comparing abdominal hysterectomy (AH) wi th transcervical resection of the endometrium (TCRE) for the condition have shown that, although the duration and severity of convalescence is less with TCRE, AH produces a permanent solution to heavy bleeding while TCRE fails in a proportion of women by 2 years. However, by 2 ye ars, TCRE costs only 71% that of AH. This paper presents a cost-utilit y analysis to assess which procedure is more cost-effective overall. U nder most plausible parameter values and on the basis of health state values elicited from a sample of women with menorrhagia, AH is likely to be considered more cost-effective than TCRE if purchasers are willi ng to pay an additional cost of at least pound 6,500 per extra quality -adjusted life-year generated by AH.