A computer model to analyze the cost-effectiveness of hormone replacement therapy

This paper gives a detailed presentation of a computer model for evaluating the cost-effectiveness (CE) of hormone replacement therapy (HRT), describi ng the model's design, structure, and data requirements. The model needs da ta specified for costs, quality of life, risks, and mortality rates. As an illustration the CE of HRT in Sweden is calculated. Two treatment strategie s are evaluated for asymptomatic women: estrogen-only therapy and estrogen combined with a progestin, The model produces similar results compared with earlier studies. The CE ratios improve with the size of the risk reduction and generally with age. Further, estrogen-only therapy is associated with a lower cost per gained effectiveness unit compared with combined therapy. Uncertainty surrounding the longterm effects of HRT means that the CE estim ates should be interpreted carefully. The model permits the inclusion of in direct costs and costs in added life-years, allowing the analysis to be mad e from a societal perspective, which is an improvement relative to previous studies.