Women with Newly Diagnosed Uterine Fibroids: Treatment Patterns and Cost Comparison for Select Treatment Options

Bonafede, Machaon; Pohlman, Scott; Miller, Jeffrey D.; Thiel, Ellen; Troeger, K.A.; Miller, Charles E.

doi:10.1089/pop.2017.0151

Cited by 23 publications

(18 citation statements)

References 21 publications

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“…We found a decrease in the percentage of hysterectomies through time, as have others. 10,26 Another explanation for the declining temporal trends in fibroid diagnoses among women age >50 years could be diminished use of postmenopausal hormone therapy associated with symptomatic uterine fibroids. 6 In addition, newer guidelines recommending initial treatment for menorrhagia as medical management 27,28 could have affected diagnostic trends; the levonorgestrel intrauterine device Annual age-adjusted uterine fibroid incidence by race/ethnicity, 2005 through 2014 X axis: year.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014

Yu¹,

Scholes²,

Schulze‐Rath³

et al. 2018

American Journal of Obstetrics and Gynecology

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BACKGROUND: Despite considerable public health burden, uterine fibroid population-based incidence estimates are few. Secular trends over time are even more limited. OBJECTIVE: We sought to evaluate the incidence, 10-year secular trends, and prevalence of uterine fibroid diagnoses and describe the proportion of symptomatic women. STUDY DESIGN: We performed a retrospective population-based cohort study of women, aged 18e65 years, enrolled 2005 through 2014 in Kaiser Permanente Washington. Uterine fibroid diagnoses identified by International Classification of Diseases, Ninth Revision codes and potential covariates were extracted from computerized databases. Women with prior hysterectomy and, for incidence estimates, women with prior fibroid diagnoses were excluded. Linear trends in incidence rates over the 10-year study period were evaluated using Poisson regression models. Rates and trend tests were examined for all women, by age groups, and by race/ethnicity. RESULTS: Associated International Classification of Diseases, Ninth Revision symptom-related codes were observed in 90% of incident cases. Incidence rates for fibroid diagnoses were highest for the age group 45e49 years, 240.3 per 10,000 woman-years in 2014, and for black women across all years. Overall age-adjusted estimated incidence rates declined during the 10-year study interval, from 139.4 per 10,000 woman-years in 2005 to 101.4 in 2014 (P value trend .0008). Overall prevalence in 2014 was 9.6%, and was highest among women aged 50e54 years (15.9%). Black women had higher prevalence (18.5%) than other racial/ethnic groups. CONCLUSION: We found a decreasing trend of new uterine fibroid diagnoses among predominantly symptomatic women ages 18e65 years in a recent 10-year interval. This finding was due, perhaps in part, to secular trends of decreasing hysterectomies. Nonetheless, uterine fibroids remain a common health burden, with a prevalence of nearly 10%. Rates are disproportionately high and occur at younger ages for black women, and possibly for other non-white racial/ethnic groups. These findings are of concern, as current available long-term medical therapies remain limited.

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Section: Commentmentioning

confidence: 99%

“…3,9 Over one third of hysterectomies in the United States are for uterine fibroids. 10 Current available pharmacological agents may have side effects and a risk of relapse after discontinuation. 11e13 Symptomatic uterine fibroids may affect up to 25% of all women and up to 30e40% of women in the perimenopausal age range.…”

Section: Introductionmentioning

confidence: 99%

A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014

Yu¹,

Scholes²,

Schulze‐Rath³

et al. 2018

American Journal of Obstetrics and Gynecology

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“…Our costs were closer to Bonafede et al, who found one-year hysterectomy costs to be up to $24,000. 9 Bonafede also looked at hysteroscopic myomectomy, which carried a mean cost of $17,300, considerably higher than the cost associated with TFA ($8,914). 9…”

Section: Discussionmentioning

confidence: 99%

“…7 Recent studies estimated average payer costs for hysterectomy ranging from $16,184-$25,499 (2016 dollars), depending upon the procedure setting and route of surgery. 8,9 A 2014 comparative effectiveness study of uterine fibroid treatments estimated the combined payer and patient direct cost per myomectomy to be $23,983. 10 With over two hundred thousand combined procedures performed per year, this would equate to nearly five hundred million dollars in complication costs per year for hysterectomies and myomectomies in the United States alone.…”

Section: Introductionmentioning

confidence: 99%

<p>The INSPIRE Comparative Cost Study: 12-Month Health Economic and Clinical Outcomes Associated with Hysterectomy, Myomectomy, and Treatment with the Sonata System</p>

Brooks¹,

Mihalov²,

Delvadia³

et al. 2020

CEOR

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Purpose: The INSPIRE study compared perioperative and 12-month health economic and clinical outcomes associated with hysterectomy, myomectomy, and sonography-guided transcervical fibroid ablation (TFA) using the Sonata ® system. Patients and Methods: Cost and health care resource utilization (HCRU) data for TFA were obtained from a prospective, multicenter, single-arm clinical trial. Data for hysterectomy and myomectomy arms were derived from the Truven Health MarketScan commercial payer claims database. The Truven data was used to determine health economic outcomes and costs for the hysterectomy and myomectomy arms. For each arm, payer perspective costs were estimated from the available charge and HCRU data. Results: TFA with Sonata had significantly lower mean length of stay (LOS) of 5 hrs versus hysterectomy (73 hrs) or myomectomy (79 hrs; all p< 0.001). The average payer cost for TFA treatment, including the associated postoperative HCRU was $8,941. This was significantly lower compared to hysterectomy ($24,156) and myomectomy ($22,784; all p< 0.001). In the TFA arm, there were no device-or procedure-related costs associated with complications during the peri-or postoperative time frame. TFA subjects had significantly lower costs associated with complications, prescription medications, and radiology. Conclusion: Compared to hysterectomy and myomectomy, TFA treatment with the Sonata system was associated with significantly lower index procedure cost, complication cost, and LOS, contributing to a lower total payer cost through 12 months.

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“…The lack of understanding about the etiology of UFs contributes to the intensive research of new medical therapies [11]. Nowadays we can observe switch to minimally invasive management which is becoming more common and is available in most health care systems [12].…”

Section: Uterine Fibroids-overviewmentioning

confidence: 99%

The Role of miRNA and Related Pathways in Pathophysiology of Uterine Fibroids—From Bench to Bedside

Ciebiera

Włodarczyk

Zgliczyński

et al. 2020

IJMS

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Uterine fibroids (UFs) are the most common benign tumors of the female genital tract. Their prevalence usually is estimated at 30–40%, but may reach up to 70–80% in predisposed groups of women. UFs may cause various clinical issues which might constitute the major reason of the overall deterioration of the quality of life. The mechanisms leading to UFs formation and growth still remain poorly understood. The transformation of smooth muscle cells of the uterus into abnormal, immortal cells, capable of clonal division, is thought to be a starting point of all pathways leading to UF formation. Micro-ribonucleic acids (miRNAs) are non-coding single-stranded RNAs about 22 nucleotides in length, that regulate gene expression. One of recent advances in this field is the comprehension of the role of miRNAs in tumorigenesis. Alterations in the levels of miRNAs are related to the formation and growth of several tumors which show a distinct miRNA signature. The aim of this review is to summarize the current data about the role of miRNAs in the pathophysiology of UFs. We also discuss future directions in the miRNA research area with an emphasis on novel diagnostic opportunities or patient-tailored therapies. In our opinion data concerning the regulation of miRNA and its gene targets in the UFs are still insufficient in comparison with gynecological malignancies. The potential translational use of miRNA and derived technologies in the clinical care is at the early phase and needs far more evidence. However, it is one of the main areas of interest for the future as the use of miRNAs in the diagnostics and treatment of UFs is a new and exciting opportunity.

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Women with Newly Diagnosed Uterine Fibroids: Treatment Patterns and Cost Comparison for Select Treatment Options

Cited by 23 publications

References 21 publications

A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014

A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014

<p>The INSPIRE Comparative Cost Study: 12-Month Health Economic and Clinical Outcomes Associated with Hysterectomy, Myomectomy, and Treatment with the Sonata System</p>

The Role of miRNA and Related Pathways in Pathophysiology of Uterine Fibroids—From Bench to Bedside

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