The cost to perform uterine fibroid embolisation in the Australian public hospital system

Abstract

Introduction: Uterine fibroids have the potential to cause morbidity, and there is a substantial cost to both the healthcare system and society. There is support for minimally invasive intervention, and uterine fibroid embolisation (UFE) is an established cost-effective option for women wishing for an alternative to surgery. There is a lack of local Australian costing data to compliment use in the public hospital system, and we offer a costing analysis of running a public hospital service. Methods: We reviewed the costs for 10 sequential uterine fibroid embolisation cases, by assessing the direct and indirect hospital costs. Results: The total cost of providing a uterine fibroid embolisation service using our model in a public hospital including initial outpatient assessment, procedure costs, overnight hospital ward stay and outpatient follow-up is $3995 per admission.Conclusion: Using our model, the overall cost to perform this procedure is low, and lower than prior estimates for surgical alternatives. We encourage government and regulatory bodies to support UFE through guidelines and remuneration models, and encourage more public Australian interventional radiology departments to offer this service.

Treatment of symptomatic fibroid disease using uterine fibroid embolisation: An Australian perspective

“…MSAC concluded that UAE was safe and cost‐effective, and decided to recommend public funding of fibroid embolisation services to Australian women, but placed a condition that referrals should come from a gynaecologist for Medicare to provide the rebate . A recently published cost analysis of performing UAE in the Australian public sector showed that the cost to perform the procedure including overnight admission was only AUD$3995 …”

“…Interventional radiologists will also need to take greater clinical ownership for post‐procedural care and this involves having an inpatient bedcard and continuing to post‐operatively manage their patient. These issues form a major hurdle for the provision of these services in many public hospitals …”

“…These issues form a major hurdle for the provision of these services in many public hospitals. 32,35 Improvements could be made toward a more open clinical discussion between gynaecologists and interventional radiologists for patients who may be suitable for either surgery or embolisation, or as an adjunct after a previous procedure. The advantages and limitations of both surgery and embolisation should be understood by both gynaecologists and interventional radiologists to ensure that the best possible patient outcomes are achieved for women.…”

The evolution of interventional radiology literature in Australia and New Zealand

“…The future of IR‐led research is bright in Australia and New Zealand. Through education of medical students and junior doctors, 25 nurturing of trainee radiologists 26 and cultivation of a culture of academia, the place of IR in JMIRO and role of IRs in Australia and New Zealand will only continue to flourish.…”

Uterine fibroid embolisation: advocating women’s choice for uterine salvage

“…While the FEMME trial showed better quality of life scores for myomectomy than for UFE, this was offset by higher complications (particularly haemorrhage requiring transfusion), longer hospital stay, and more patients in the UFE group reported a pregnancy. Coupling this with the low cost to perform (Clements et al 2020b ), the data to support UFE has never been more robust, and we must now permanently put scepticism in the graveyard.…”