Brooks Elizabeth, Mihalov Linda, Delvadia Dipak, Hudgens Joseph, Mama Saifuddin, Makai Gretchen E, Yuen Matt W, Little Carter A, Bauserman Robert L, Zambelli-Weiner April, Levine David J
TTi Health Research & Economics, Westminster, MD, USA.
Benaroya Research Institute at Virginia Mason Medical Center, Seattle, WA, USA.
Clinicoecon Outcomes Res. 2020 Jan 8;12:1-11. doi: 10.2147/CEOR.S214755. eCollection 2020.
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.
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.
TFA with Sonata had significantly lower mean length of stay (LOS) of 5 hrs versus hysterectomy (73 hrs) or myomectomy (79 hrs; all < 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 < 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.
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.
INSPIRE研究比较了子宫切除术、子宫肌瘤切除术以及使用索纳塔系统进行超声引导下经宫颈子宫肌瘤消融术（TFA）的围手术期和12个月的健康经济及临床结局。
TFA的成本和医疗保健资源利用（HCRU）数据来自一项前瞻性、多中心、单臂临床试验。子宫切除术和子宫肌瘤切除术组的数据来自Truven Health MarketScan商业医保索赔数据库。Truven数据用于确定子宫切除术和子宫肌瘤切除术组的健康经济结局及成本。对于每组，从可用的收费和HCRU数据估算医保支付方视角的成本。
使用索纳塔系统的TFA平均住院时间显著更短，为5小时，而子宫切除术为73小时，子宫肌瘤切除术为79小时（均P<0.001）。TFA治疗的平均医保支付方成本，包括相关的术后HCRU，为8941美元。这显著低于子宫切除术（24156美元）和子宫肌瘤切除术（22784美元；均P<0.001）。在TFA组，围手术期或术后期间没有与并发症相关的器械或手术成本。TFA受试者与并发症、处方药和放射学相关的成本显著更低。
与子宫切除术和子宫肌瘤切除术相比，使用索纳塔系统的TFA治疗与显著更低的索引手术成本、并发症成本和住院时间相关，在12个月内使医保支付方的总成本更低。
