Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment
Abstract Background To evaluate the potential benefits of the Magnetic Resonance-guided high intensity Focused Ultrasound (MRgFUS) introduction in the clinical practice, for the treatment of uterine fibroids, in comparison with the standard “conservative” procedures, devoted to women who wish to pre...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | Health Economics Review |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13561-022-00367-x |
| _version_ | 1818356271816900608 |
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| author | L. Ferrario E. Garagiola C. Gerardi G. Bellavia S. Colombo C. Ticca C. Rossetti M. Ciboldi M. Meroni A. Vanzulli A. Rampoldi T. Bignardi F. Arrigoni E. Porazzi E. Foglia |
| author_facet | L. Ferrario E. Garagiola C. Gerardi G. Bellavia S. Colombo C. Ticca C. Rossetti M. Ciboldi M. Meroni A. Vanzulli A. Rampoldi T. Bignardi F. Arrigoni E. Porazzi E. Foglia |
| author_sort | L. Ferrario |
| collection | DOAJ |
| description | Abstract Background To evaluate the potential benefits of the Magnetic Resonance-guided high intensity Focused Ultrasound (MRgFUS) introduction in the clinical practice, for the treatment of uterine fibroids, in comparison with the standard “conservative” procedures, devoted to women who wish to preserve their uterus or enhance fertility: myomectomy and uterine artery embolization (UAE). Methods A Health Technology Assessment was conducted, assuming the payer’s perspective (Italian National Healthcare Service). The nine EUnetHTA Core Model dimensions were deeply investigated, by means of i) a literature review; ii) the implementation of health economics tools (useful for uterine fibroids patients’ clinical pathway economic evaluation, and budget impact analysis), to define MRgFUS economic and organizational sustainability, and iii) administration of specific questionnaires filled by uterine fibroids’ experts, to gather their perceptions on the three possible conservative approaches (MRgFUS, UAE and myomectomy). Results Literature revealed that MRgFUS would generate several benefits, from a safety and an efficacy profile, with significant improvement in symptoms relief. Advantages emerged concerning the patients’ perspective, thus leading to a decrease both in the length of hospital stay (p-value< 0.001), and in patients’ productivity loss (p-value = 0.024). From an economic point of view, the Italian NHS would present an economic saving of − 6.42%. A positive organizational and equity impact emerged regarding the capability to treat a larger number of women, thus performing, on average, 131.852 additional DRGs. Conclusions Results suggest that MRgFUS could be considered an advantageous technological alternative to adopt within the target population affected by uterine fibroids, demonstrating its economic and organisational feasibility and sustainability, with consequent social benefits. |
| first_indexed | 2024-12-13T19:54:34Z |
| format | Article |
| id | doaj.art-fc9f381073494bc0855e8d0b0ccb1e02 |
| institution | Directory Open Access Journal |
| issn | 2191-1991 |
| language | English |
| last_indexed | 2024-12-13T19:54:34Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Economics Review |
| spelling | doaj.art-fc9f381073494bc0855e8d0b0ccb1e022022-12-21T23:33:21ZengBMCHealth Economics Review2191-19912022-03-0112111010.1186/s13561-022-00367-xInnovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessmentL. Ferrario0E. Garagiola1C. Gerardi2G. Bellavia3S. Colombo4C. Ticca5C. Rossetti6M. Ciboldi7M. Meroni8A. Vanzulli9A. Rampoldi10T. Bignardi11F. Arrigoni12E. Porazzi13E. Foglia14Centre for Health Economics, Social and Health Care Management, LIUC- Università CattaneoCentre for Health Economics, Social and Health Care Management, LIUC- Università CattaneoIRCCS- Istituto di Ricerche Farmacologiche “Mario Negri”ASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaASST Grande Ospedale Metropolitano NiguardaUniversity of L’AquilaCentre for Health Economics, Social and Health Care Management, LIUC- Università CattaneoCentre for Health Economics, Social and Health Care Management, LIUC- Università CattaneoAbstract Background To evaluate the potential benefits of the Magnetic Resonance-guided high intensity Focused Ultrasound (MRgFUS) introduction in the clinical practice, for the treatment of uterine fibroids, in comparison with the standard “conservative” procedures, devoted to women who wish to preserve their uterus or enhance fertility: myomectomy and uterine artery embolization (UAE). Methods A Health Technology Assessment was conducted, assuming the payer’s perspective (Italian National Healthcare Service). The nine EUnetHTA Core Model dimensions were deeply investigated, by means of i) a literature review; ii) the implementation of health economics tools (useful for uterine fibroids patients’ clinical pathway economic evaluation, and budget impact analysis), to define MRgFUS economic and organizational sustainability, and iii) administration of specific questionnaires filled by uterine fibroids’ experts, to gather their perceptions on the three possible conservative approaches (MRgFUS, UAE and myomectomy). Results Literature revealed that MRgFUS would generate several benefits, from a safety and an efficacy profile, with significant improvement in symptoms relief. Advantages emerged concerning the patients’ perspective, thus leading to a decrease both in the length of hospital stay (p-value< 0.001), and in patients’ productivity loss (p-value = 0.024). From an economic point of view, the Italian NHS would present an economic saving of − 6.42%. A positive organizational and equity impact emerged regarding the capability to treat a larger number of women, thus performing, on average, 131.852 additional DRGs. Conclusions Results suggest that MRgFUS could be considered an advantageous technological alternative to adopt within the target population affected by uterine fibroids, demonstrating its economic and organisational feasibility and sustainability, with consequent social benefits.https://doi.org/10.1186/s13561-022-00367-xEconomic evaluationTechnology assessmentMagnetic resonance imaging/methodsUltrasound therapy/methodsDecision support techniques |
| spellingShingle | L. Ferrario E. Garagiola C. Gerardi G. Bellavia S. Colombo C. Ticca C. Rossetti M. Ciboldi M. Meroni A. Vanzulli A. Rampoldi T. Bignardi F. Arrigoni E. Porazzi E. Foglia Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment Health Economics Review Economic evaluation Technology assessment Magnetic resonance imaging/methods Ultrasound therapy/methods Decision support techniques |
| title | Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment |
| title_full | Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment |
| title_fullStr | Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment |
| title_full_unstemmed | Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment |
| title_short | Innovative and conventional “conservative” technologies for the treatment of uterine fibroids in Italy: a multidimensional assessment |
| title_sort | innovative and conventional conservative technologies for the treatment of uterine fibroids in italy a multidimensional assessment |
| topic | Economic evaluation Technology assessment Magnetic resonance imaging/methods Ultrasound therapy/methods Decision support techniques |
| url | https://doi.org/10.1186/s13561-022-00367-x |
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