Treatment methods for cervical intraepithelial neoplasia in England: A cost-effectiveness analysis

IF 5.4 3区 材料科学 Q2 CHEMISTRY, PHYSICAL
Michela Tinelli, Antonios Athanasiou, Areti Angeliki Veroniki, Orestis Efthimiou, Ilkka Kalliala, Sarah Bowden, Maria Paraskevaidi, Deirdre Lyons, Pierre Martin-Hirsch, Phillip Bennett, Evangelos Paraskevaidis, Georgia Salanti, Maria Kyrgiou, Huseyin Naci
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引用次数: 0

Abstract

Objective

To compare the cost-effectiveness of different treatments for cervical intraepithelial neoplasia (CIN).

Design

A cost-effectiveness analysis based on data available in the literature and expert opinion.

Setting

England.

Population

Women treated for CIN.

Methods

We developed a decision-analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10 years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10-year period. The costs calculated were those incurred by the National Health Service (NHS) of England.

Main outcome measures

Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted.

Results

For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost-effective treatment overall at all willingness-to-pay thresholds. For postmenopausal women, LLETZ remained the most cost-effective treatment up to a threshold of £31,500, but laser conisation became the most cost-effective treatment above that threshold.

Conclusions

LLETZ is the most cost-effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than £31,500 to avert one CIN2+ recurrence.

Abstract Image

英格兰宫颈上皮内瘤变的治疗方法:成本效益分析
比较宫颈上皮内瘤变(CIN)不同治疗方法的成本效益。
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来源期刊
ACS Applied Energy Materials
ACS Applied Energy Materials Materials Science-Materials Chemistry
CiteScore
10.30
自引率
6.20%
发文量
1368
期刊介绍: ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.
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