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Cost-effectiveness of Vaginal Estrogen and Selecti ...
Cost-effectiveness of Vaginal Estrogen and Selective Estrogen Receptor Modulator Therapy vs. Fractional Vaginal Laser for Treatment of Genitourinary Syndrome of Menopause - Helai Hesham, MD
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Pdf Summary
This study aimed to compare the cost-effectiveness of traditional therapy (vaginal estrogen and non-hormonal vaginal lubricants) versus fractional vaginal CO2 laser therapy (CO2LT) for genitourinary syndrome of menopause (GSM). The cost-effectiveness analysis (CEA) showed that fractional laser and vaginal estrogen were equivalent, even when varying the cost of laser. Only when the cost of laser was 47% of the lowest current price was it the most cost-effective option. Selective estrogen receptor modulator (SERM) therapy was consistently the least cost-effective option. The CEA was conducted using TreeAge Pro 2018, with inputs derived from published primary literature on effectiveness and side effects. Out-of-pocket costs for patients were calculated using Medicare Part D pricing and retail costs, while CO2LT cost was obtained from providers in the greater Boston area. The study used quality-adjusted life years (QALYs) to measure effectiveness and U.S. dollars (USD) for costs. The authors noted that data on both clinical effectiveness and adverse effects of CO2LT are limited, and the CEA findings may change as new data become available. In the base case analysis, fractional laser therapy dominated over SERM and was equivalent to vaginal estrogen. The study concluded that, based on current effectiveness data, fractional laser therapy and vaginal estrogen are equally cost-effective. However, the CEA findings may be subject to change as more data becomes available. The contact information of the researchers is provided for further inquiries.
Keywords
traditional therapy
vaginal estrogen
non-hormonal vaginal lubricants
fractional vaginal CO2 laser therapy
genitourinary syndrome of menopause
cost-effectiveness analysis
selective estrogen receptor modulator
TreeAge Pro 2018
quality-adjusted life years
U.S. dollars
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