Mai Thi Tuyet Kieu, Minh Hong Le, Chi Phuong Nguyen
{"title":"dienogest与促性腺激素释放激素激动剂在越南治疗子宫内膜异位症的成本效益比较。","authors":"Mai Thi Tuyet Kieu, Minh Hong Le, Chi Phuong Nguyen","doi":"10.1186/s12962-025-00655-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis-related dysmenorrhea and pelvic pain impose significant economic and quality-of-life burdens. This study evaluated the cost-effectiveness of dienogest compared to gonadotropin-releasing hormone agonists (GnRH-a) for managing dysmenorrhea and pelvic pain in Vietnam.</p><p><strong>Design: </strong>The cost-effectiveness analysis using a Markov model was conducted from a healthcare payer perspective. Model input parameters were obtained from meta-analyses, published literature, and local data sources. One-way sensitivity, and probabilistic sensitivity analyses (PSA) were performed to assess the robustness of the findings.</p><p><strong>Setting: </strong>Vietnamese healthcare system context.</p><p><strong>Participants: </strong>Hypothetical cohort of women with endometriosis experiencing dysmenorrhea or pelvic pain.</p><p><strong>Interventions: </strong>Dienogest compared with GnRH-a therapies (triptorelin, leuprorelin, goserelin).</p><p><strong>Main outcome measures: </strong>Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated over two years.</p><p><strong>Results: </strong>Dienogest was the dominant treatment for dysmenorrhea, with the lowest cost ($363.3) and highest QALYs (1.74) compared to triptorelin ($739.3; 1.62 QALYs; ICER -$3,292/QALY) and leuprorelin ($744.0; 1.70 QALYs; ICER -$11,454/QALY). For pelvic pain, dienogest ($381.5, 1.64 QALYs) also dominated triptorelin ($720.4; 1.60 QALYs; ICER -$10,919/QALY), leuprorelin ($773.4; 1.54 QALYs; ICER -$4,300/QALY), and goserelin ($753.1; 1.49 QALYs; ICER -$2,609/QALY).One-way sensitivity analysis identified the probability of symptom resolution and utility values as key drivers of cost-effectiveness. PSA confirmed dienogest's high probability (≥ 99%) of being cost-effective at a willingness-to-pay threshold of one GDP per capita.</p><p><strong>Conclusion: </strong>Dienogest is a cost-effective alternative to GnRH-a drugs for treating dysmenorrhea and pelvic pain in Vietnam, offering improved health outcomes at a lower cost. These findings support its broader adoption in clinical practice and healthcare policy.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"51"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482696/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of dienogest compared to gonadotropin releasing hormone agonists for the management of endometriosis in Vietnam.\",\"authors\":\"Mai Thi Tuyet Kieu, Minh Hong Le, Chi Phuong Nguyen\",\"doi\":\"10.1186/s12962-025-00655-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Endometriosis-related dysmenorrhea and pelvic pain impose significant economic and quality-of-life burdens. This study evaluated the cost-effectiveness of dienogest compared to gonadotropin-releasing hormone agonists (GnRH-a) for managing dysmenorrhea and pelvic pain in Vietnam.</p><p><strong>Design: </strong>The cost-effectiveness analysis using a Markov model was conducted from a healthcare payer perspective. Model input parameters were obtained from meta-analyses, published literature, and local data sources. One-way sensitivity, and probabilistic sensitivity analyses (PSA) were performed to assess the robustness of the findings.</p><p><strong>Setting: </strong>Vietnamese healthcare system context.</p><p><strong>Participants: </strong>Hypothetical cohort of women with endometriosis experiencing dysmenorrhea or pelvic pain.</p><p><strong>Interventions: </strong>Dienogest compared with GnRH-a therapies (triptorelin, leuprorelin, goserelin).</p><p><strong>Main outcome measures: </strong>Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated over two years.</p><p><strong>Results: </strong>Dienogest was the dominant treatment for dysmenorrhea, with the lowest cost ($363.3) and highest QALYs (1.74) compared to triptorelin ($739.3; 1.62 QALYs; ICER -$3,292/QALY) and leuprorelin ($744.0; 1.70 QALYs; ICER -$11,454/QALY). For pelvic pain, dienogest ($381.5, 1.64 QALYs) also dominated triptorelin ($720.4; 1.60 QALYs; ICER -$10,919/QALY), leuprorelin ($773.4; 1.54 QALYs; ICER -$4,300/QALY), and goserelin ($753.1; 1.49 QALYs; ICER -$2,609/QALY).One-way sensitivity analysis identified the probability of symptom resolution and utility values as key drivers of cost-effectiveness. PSA confirmed dienogest's high probability (≥ 99%) of being cost-effective at a willingness-to-pay threshold of one GDP per capita.</p><p><strong>Conclusion: </strong>Dienogest is a cost-effective alternative to GnRH-a drugs for treating dysmenorrhea and pelvic pain in Vietnam, offering improved health outcomes at a lower cost. 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Cost-effectiveness of dienogest compared to gonadotropin releasing hormone agonists for the management of endometriosis in Vietnam.
Objectives: Endometriosis-related dysmenorrhea and pelvic pain impose significant economic and quality-of-life burdens. This study evaluated the cost-effectiveness of dienogest compared to gonadotropin-releasing hormone agonists (GnRH-a) for managing dysmenorrhea and pelvic pain in Vietnam.
Design: The cost-effectiveness analysis using a Markov model was conducted from a healthcare payer perspective. Model input parameters were obtained from meta-analyses, published literature, and local data sources. One-way sensitivity, and probabilistic sensitivity analyses (PSA) were performed to assess the robustness of the findings.
Setting: Vietnamese healthcare system context.
Participants: Hypothetical cohort of women with endometriosis experiencing dysmenorrhea or pelvic pain.
Interventions: Dienogest compared with GnRH-a therapies (triptorelin, leuprorelin, goserelin).
Main outcome measures: Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated over two years.
Results: Dienogest was the dominant treatment for dysmenorrhea, with the lowest cost ($363.3) and highest QALYs (1.74) compared to triptorelin ($739.3; 1.62 QALYs; ICER -$3,292/QALY) and leuprorelin ($744.0; 1.70 QALYs; ICER -$11,454/QALY). For pelvic pain, dienogest ($381.5, 1.64 QALYs) also dominated triptorelin ($720.4; 1.60 QALYs; ICER -$10,919/QALY), leuprorelin ($773.4; 1.54 QALYs; ICER -$4,300/QALY), and goserelin ($753.1; 1.49 QALYs; ICER -$2,609/QALY).One-way sensitivity analysis identified the probability of symptom resolution and utility values as key drivers of cost-effectiveness. PSA confirmed dienogest's high probability (≥ 99%) of being cost-effective at a willingness-to-pay threshold of one GDP per capita.
Conclusion: Dienogest is a cost-effective alternative to GnRH-a drugs for treating dysmenorrhea and pelvic pain in Vietnam, offering improved health outcomes at a lower cost. These findings support its broader adoption in clinical practice and healthcare policy.
期刊介绍：
Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.
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