Abstract：
OBJECTIVE:This study aims to compare the cost-effectiveness of oral contraceptives (OCs), the levonorgestrel-releasing intrauterine system (LNG-IUS) and surgical management in treating dysfunctional uterine bleeding (DUB) in women not desiring additional children. METHOD:A Markov model was constructed from the perspective of the health services payers for a 5-year period. Treatment costs, DUB treatment success rates and contraception success rates were obtained through a literature review. RESULTS:In women not responding to an initial trial of OCs, surgical management was more effective than the LNG-IUS (95.5% vs. 92%) but at higher cost (US$4853 vs. US$2796 per woman). Among responders to OCs, continuing treatment with the LNG-IUS instead of OCs was more effective (92% vs. 90.4%) and less expensive (US$2796 vs. US$4711). For women naïve to medical therapy, the LNG-IUS and OCs had similar effectiveness, but cost for the LNG-IUS was lower (US$2796 vs. US$4895). In all scenarios, surgery followed if medical therapy failed; rates of primary method failure were 62.5% with OCs and 34% with the LNG-IUS at 12 months. CONCLUSIONS:Treatment strategies employing the LNG-IUS are the most cost-effective in managing DUB, regardless of whether a woman has previously tried OC therapy.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Blumenthal PD,Trussell J,Singh RH,Guo A,Borenstein J,Dubois RW,Liu Zdoi
10.1016/j.contraception.2006.03.024subject
Has Abstractpub_date
2006-09-01 00:00:00pages
249-58issue
3eissn
0010-7824issn
1879-0518pii
S0010-7824(06)00118-1journal_volume
74pub_type
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